Individual provider Active NPI

Kevin Dul, MD

  • Diagnostic Radiology Physician
  • Gastonia, NC
National Provider Identifier
1972587798
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
200200347 Issued in NC
Practice address
620 Summit Crossing PL
Ste 106
Gastonia, NC 28054-2176
Phone
(704) 867-8021
Fax
(804) 864-4606
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 200200347 NC
Diagnostic Radiology Physician 2085R0202X 200200347 NC Primary

Addresses

Primary practice location

620 Summit Crossing PL
Ste 106
Gastonia, NC 28054-2176

Mailing address

620 Summit Crossing PL
Ste 106
Gastonia, NC 28054-2176
Phone (704) 867-8021

Other identifiers 9

IdentifierTypeStateIssuer
B7685OtherMEDCOST
2829724OtherAETNA HMO
5534697OtherAETNA PPO
89133XAMedicaidNC
N00347MedicaidSC
133XAOtherBLUE CROSS BLUE SHIELD
802658OtherPARTNERS
16 01363OtherUNITED HEALTHCARE
300135816OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Radiology Diagnostic Radiology Current Accepting new patients

Locations

620 Summit Crossing Pl
Ste 106
Gastonia, NC 28054
Phone (704) 864-4378

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1972587798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SUMMIT CROSSING PL",
            "address_2": "STE 106",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542176",
            "telephone_number": "704-867-8021",
            "fax_number": "804-864-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SUMMIT CROSSING PL",
            "address_2": "STE 106",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542176",
            "telephone_number": "704-867-8021",
            "fax_number": "804-864-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUL",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "200200347",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200200347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B7685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2829724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5534697",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133XA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00347",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "133XA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "802658",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "16 01363",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300135816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.