NPIMap

Individual provider Active NPI

Melissa Cline Mathis, PA-C

  • Physician Assistant
  • Gastonia, NC
National Provider Identifier
1972558476
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05141 Issued in NC
Practice address
2555 Court Dr Ste 350
Gastonia, NC 28054-2186
Phone
(704) 834-2465
Fax
(704) 834-2466
NPI assigned
May 23, 2006
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05141 NC Primary
Medical Physician Assistant 363AM0700X 0010-05141 NC

Addresses

Primary practice location

2555 Court Dr Ste 350
Gastonia, NC 28054-2186

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Other identifiers 1

IdentifierTypeStateIssuer
0303PAMedicaidSC

Other names 1

  • Melissa Cline Loos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916002259 NC Practitioner - Physician Assistant 5799732319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

2555 Court Dr
Suite 350
Gastonia, NC 28054-2186
Phone (704) 834-2465

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-05141NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Aug 4, 2014 Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 4, 2014 Accepting new patients
Careteam Plus, Inc. Past Accepting new patients
Careteam Plus, Inc. Past Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2555 Court Dr
Ste 350
Gastonia, NC 28054
Phone (704) 671-6912

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

2711 X Ray Dr
Ste 3700
Gastonia, NC 28054
Phone (704) 834-2465

Interoperability endpoints

  • Direct secure messaging: mmathis816443@direct.novanthealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1972558476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 350",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542186",
            "telephone_number": "704-834-2465",
            "fax_number": "704-834-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "MELISSA",
        "middle_name": "CLINE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05141",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-05141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "LOOS",
            "middle_name": "CLINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.