ASHLEY PENDLETON GAINES MD
NPI 1811967771
Internal Medicine in Harrisburg, NC

Q: What is Ashley Gaines's NPI number?

The NPI number for Ashley Gaines is 1811967771. It was assigned to this individual provider in the NPPES registry on January 24, 2006.

Q: What is Ashley Gaines's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ashley Gaines was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since January 24, 2006PECOS Enrolled

100/100

CMS Quality Rating

5427 NC HIGHWAY 49 S, STE 102, HARRISBURG, NC 28075(704) 454-7360 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2024, May 4, 2023, Mar 9, 2023 and 41 more (44 updates tracked since 2018).

On this page

About Ashley Pendleton Gaines Md NPPES

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

ASHLEY PENDLETON GAINES MD (NPI 1811967771) is an individual internal medicine provider in Harrisburg, North Carolina, licensed in North Carolina (200200356) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center-northeast, and maintains a secondary practice location in Concord.

NPPES Registry Identity

NPI1811967771

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameASHLEY PENDLETON GAINESCredential: MD

Location Address5427 NC HIGHWAY 49 S, STE 102Harrisburg, NC 28075-7408

Mailing AddressPo Box 19305Charlotte, NC 28219-9305

Phone(704) 454-7360

Sole ProprietorNo

Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 1999

Enumeration DateJanuary 24, 2006

Last NPPES UpdateJuly 15, 202444 updates tracked since enumeration

NPPES CertifiedMarch 4, 2020

✔ NPI 1811967771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NC · 200200356

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.

5427 NC HIGHWAY 49 S, Harrisburg, NC 28075

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Secondary Practice Location 1

Location 11085 NE Gateway Ct NE, Ste 200Concord, NC 28025-2406 · Phone (704) 403-8650

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ashley Pendleton Gaines Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648259028

PECOS Enrollment IDI20040719000749

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ashley Gaines reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carolinas Physicians Network Inc

1.1 mi

Obstetrics & Gynecology

4315 PHYSICIANS BLVD, STE 201
Harrisburg, NC 28075

Reassigned Medicare billing, North Carolina enrollment
2,057 clinicians in this Medicare group

NPI 1366765893 (704) 786-7158

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

438 services213 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

117 services117 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

82 services28 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

63 services61 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

62 services50 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

61 services59 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

37 services31 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

30 services30 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

29 services29 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

19 services17 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

17 services16 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

15 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carolinas Medical Center-Northeast

Acute Care Hospitals · Concord, NC

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340001

Location920 Church St NConcord, NC 28025 · Cabarrus County

Emergency services Birthing friendly

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340113

Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County

Emergency services Birthing friendly

Stanly Regional Medical Center

Acute Care Hospitals · Albemarle, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340119

Location301 Yadkin StAlbemarle, NC 28001 · Stanly County

Emergency services Birthing friendly

Atrium Health University City

Acute Care Hospitals · Charlotte, NC

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340166

Location8800 North Tyron StreetCharlotte, NC 28262 · Mecklenburg County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers25 claims71 services$5.76 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers15 claims19 services$0.83 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers11 claims11 services$15.03 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers35 claims35 services$61.18 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

5 suppliers47 claims47 services$196.30 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

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

KARINA KILLOUGH LCMHC

Counselor

5427 NC HIGHWAY 49 S, STE 105
HARRISBURG, NC 28075

Cabarrus County (704) 454-7268

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Psychiatry & Neurology (Child & Adolescent Psychiatry)

5427 NC HIGHWAY 49 S, STE 105
HARRISBURG, NC 28075

Cabarrus County (704) 454-7268

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Pediatrics

5427 NC HIGHWAY 49 S, STE 103
HARRISBURG, NC 28075

Cabarrus County (704) 455-5565

GEORGE DAVE ROBINETTE II MD

Psychiatry & Neurology (Psychiatry)

5427 NC HIGHWAY 49 S, STE 105
HARRISBURG, NC 28075

Cabarrus County (704) 454-7268

RICHARD A. FELLMAN MD

Psychiatry & Neurology (Psychiatry)

5427 NC HIGHWAY 49 S, STE 105
HARRISBURG, NC 28075

Cabarrus County (704) 454-7268

PATRICIA LYN NUSE MD

Pediatrics

5427 NC HIGHWAY 49 S, STE 103
HARRISBURG, NC 28075

Cabarrus County (704) 455-5565

AMIRAH LACHAUNE SHAREEF MD

Pediatrics

5427 NC HIGHWAY 49 S, STE 103
HARRISBURG, NC 28075

Cabarrus County (704) 455-5565

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Internal Medicine

5427 NC HIGHWAY 49 S, STE 102
HARRISBURG, NC 28075

Cabarrus County (704) 454-7360

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 Ashley Gaines's NPI number?

The NPI number for Ashley Gaines is 1811967771. It was assigned to this individual provider in the NPPES registry on January 24, 2006.

Where is Ashley Gaines located?

Ashley Gaines practices at 5427 Nc Highway 49 S Ste 102, Harrisburg, NC 28075. The listed phone number is (704) 454-7360.

What is Ashley Gaines's specialty?

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

Is Ashley Gaines enrolled in Medicare?

Yes. Ashley Gaines is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ashley Gaines's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ashley Gaines reassigns Medicare benefits to Carolinas Physicians Network Inc (Harrisburg, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ashley Gaines's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ashley Gaines accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Oscar Health Plan of North Carolina, Inc and 1 other insurer list Ashley Gaines as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ashley Gaines affiliated with any hospitals?

According to CMS data, Ashley Gaines is affiliated with Carolinas Medical Center-Northeast, Carolinas Medical Center/Behav Health, Stanly Regional Medical Center and Atrium Health University City.

When was this NPI record last updated?

The NPPES record for Ashley Gaines was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.