1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Family Medicine
  6. NPI Profile

GINA LICAUSE MD
NPI 1699762039
Family Medicine in Charlotte, NC

Active since September 30, 2005
101 E WT HARRIS BLVD, STE 5002, CHARLOTTE, NC 28262(704) 801-7310 Get Directions Write a Review

NPPES record last updated: September 27, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 27, 2021, Sep 20, 2021, Sep 15, 2021 and 12 more (15 updates tracked since 2019).

About Gina Licause Md NPPES

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

GINA LICAUSE MD (NPI 1699762039) is an individual family medicine provider in Charlotte, North Carolina, licensed in North Carolina (35695) and active in the NPI registry since September 2005. She maintains 4 additional practice locations.

NPPES Registry Identity

NPI1699762039
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameGINA LICAUSECredential: MD
Location Address101 E WT HARRIS BLVD, STE 5002Charlotte, NC 28262-3485
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 801-7310
Sole ProprietorNo
Enumeration DateSeptember 30, 2005
Last NPPES UpdateSeptember 27, 202115 updates tracked since enumeration
NPPES CertifiedMay 3, 2020
✔ NPI 1699762039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 35695
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
101 E WT HARRIS BLVD, Charlotte, NC 28262
Open in Google Maps ↗

Secondary Practice Locations 4

Location 114214 Ballantyne Lake Rd, Ste 100Charlotte, NC 28277-3372 · Phone (704) 667-2650
Location 210226 Couloak Dr, Ste 100Charlotte, NC 28216-7675 · Phone (704) 801-7380
Location 3101 E W T Harris Blvd, Ste 5401Charlotte, NC 28262-3485 · Phone (704) 863-9700
Location 4150 Professional Park Dr, Ste 400Mooresville, NC 28117-5603 · Phone (704) 801-7360

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
40%20 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
90%188 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
87%45 patients4/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
100%25 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
83%269 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
49%298 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
74%170 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

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

MACKENZIE TUZZOLO MD
Family Medicine
101 E WT HARRIS BLVD, BUILDING 1000 STE 1110
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-9850
EMILY JOHNSTON RD
Dietitian, Registered
101 E WT HARRIS BLVD, SUITE 2122B
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-6548
CAROLINAS MEDICAL CENTER-NORTHEAST
Internal Medicine (Endocrinology, Diabetes & Metabolism)
101 E WT HARRIS BLVD, BLDG 3000, SUITE 3301-F
CHARLOTTE, NC 28262
Mecklenburg County (704) 403-8320
DANNY HONEYCUTT MD
Family Medicine
101 E WT HARRIS BLVD
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-9850
ANNA CALDWELL NP
Nurse Practitioner
101 E WT HARRIS BLVD, BUILDING 1000 SUITE 1110
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-9850
ROBERT BRANDON CLARK FNP
Nurse Practitioner (Family)
101 E WT HARRIS BLVD, BLDG 5000 SUITE #5101
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-5847
ORTHOCAROLINA PA
Orthopaedic Surgery
101 E WT HARRIS BLVD, SUITE 1110
CHARLOTTE, NC 28262
Mecklenburg County (704) 339-1073
NANCY DURNING NP
Nurse Practitioner
101 E WT HARRIS BLVD, SUITE 5002
CHARLOTTE, NC 28262
Mecklenburg County (704) 863-9700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gina Licause's NPI number?

The NPI number for Gina Licause is 1699762039. It was assigned to this individual provider in the NPPES registry on September 30, 2005.

Where is Gina Licause located?

Gina Licause practices at 101 E Wt Harris Blvd Ste 5002, Charlotte, NC 28262. The listed phone number is (704) 801-7310.

What is Gina Licause's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Gina Licause was last updated on September 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.