Gaston Digestive Disease Clinic, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

23513 Issued in NC

Legal business name

GASTON DIGESTIVE DISEASE CLINIC, P.A.

Practice address

2550 Court Dr Ste 201
Gastonia, NC 28054-2152

Phone

(704) 867-3585

Fax

(704) 861-1779

NPI assigned

Apr 19, 2007

Last updated

Apr 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel Thomas Drake I, M.D.

Title

President

Phone

(704) 867-3585

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1962629493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 COURT DR STE 201",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542152",
            "telephone_number": "704-867-3585",
            "fax_number": "704-861-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 COURT DR STE 201",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542152",
            "telephone_number": "704-867-3585",
            "fax_number": "704-861-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON DIGESTIVE DISEASE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-867-3585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "23513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gaston County Health Department
• Gaston County Health Department
• Gaston County Health Department
• Gaston County Schools
• Gaston Dermatology Clinic P.a.
• Gaston Enterprises Inc (Medical Center Pharmacy)
• Gaston Enterprises Inc (Medical Center Pharmacy)
• Gaston Enterprises, Inc. (Medical Center Pharmacy)
• Gaston Eye Associates
• Gaston Eye Associates

• Specialist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.