GASTONIA MEDICAL SPECIALTY CLINIC PA - NPI 1023048279 - Internal Medicine in Gastonia, NC

Q: What is Gastonia Medical Specialty Clinic PA's NPI number?

The NPI number for Gastonia Medical Specialty Clinic PA is 1023048279. It was assigned to this organization in the NPPES registry on July 4, 2006.

Q: What is Gastonia Medical Specialty Clinic PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

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About Gastonia Medical Specialty Clinic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GASTONIA MEDICAL SPECIALTY CLINIC PA (NPI 1023048279) is a healthcare organization registered as an internal medicine in Gastonia, North Carolina and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 2, 2027 and lists Mikell J Jarratt, Corporate Officer - President, as its authorized official.

NPPES Registry Identity

NPI1023048279

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameGASTONIA MEDICAL SPECIALTY CLINIC PA

Location Address1021 X RAY DRGastonia, NC 28054-7489

Mailing Address1021 X Ray DrGastonia, NC 28054-7489 · (704) 867-2341 · Fax (704) 867-9019

Phone(704) 867-2341

Fax(704) 867-9019

Organization SubpartNo

Authorized OfficialMikell J JarrattCorporate Officer - President · (704) 867-2341

Enumeration DateJuly 4, 2006

Last NPPES UpdateOctober 8, 2014

✔ NPI 1023048279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1021 X RAY DR, Gastonia, NC 28054

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Other Identifiers 5

Other01627NC · Bcbsnc Group Provider #

OtherCC5252NC · Railroad Medicare

Medicaid5920537NC

Medicare ID-Type Unspecified0343NC

MedicaidNPA701SC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0243045

Gastonia Medical Specialty Clinic PA · Gastonia, NC

Active · expires Mar 2, 2027

CLIA Number34D0243045

Laboratory TypePhysician Office

Certificate Effective DateMarch 3, 2025

Certificate Expiration DateMarch 2, 2027

Laboratory DirectorDr. Mikell J. Jarratt

Laboratory Phone(704) 867-2341

Laboratory LocationGastonia Medical Specialty Clinic PA1021 X-Ray Drive, Gastonia, NC 28054

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GASTONIA MEDICAL SPECIALTY CLINIC PA

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