| Eastridge Family Medicine | |
|
1896 Remount Rd Gastonia NC 28054-7414 | |
| (704) 512-3930 | |
| Not Available |
| Full Name | Eastridge Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1896 Remount Rd, Gastonia, North Carolina |
| Authorized Official Name and Position | Scott Rissmiller (ENTERPRISE EVP) |
| Authorized Official Contact | 7043558675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastridge Family Medicine Po Box 19305 Charlotte NC 28219-9305 Ph: (704) 631-0002 | Eastridge Family Medicine 1896 Remount Rd Gastonia NC 28054-7414 Ph: (704) 512-3930 |
| NPI Number | 1477589158 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 03/09/2023 |
| Medicare PECOS PAC ID | 2466401666 |
|---|---|
| Medicare Enrollment ID | O20050114000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477589158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel S Senft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437175890 PECOS PAC ID: 2365474228 Enrollment ID: I20050831000688 |
| Provider Name | Everlyn Hall-baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174574149 PECOS PAC ID: 5496750572 Enrollment ID: I20060923000024 |
| Provider Name | Cordula Faye Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710111489 PECOS PAC ID: 3870759970 Enrollment ID: I20120718000000 |
| Provider Name | Amy L Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285019000 PECOS PAC ID: 9234448069 Enrollment ID: I20151019001303 |
| Provider Name | Elizabeth Kathleen Cirullo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326489725 PECOS PAC ID: 0143458034 Enrollment ID: I20160829002134 |
| Provider Name | Samantha Ellen Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063910974 PECOS PAC ID: 6901168921 Enrollment ID: I20180402001355 |
| Provider Name | Jennifer Leigh Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023671070 PECOS PAC ID: 9133456403 Enrollment ID: I20190808002759 |
| Provider Name | Jakita Charelle Strong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124638317 PECOS PAC ID: 1456769132 Enrollment ID: I20210419000372 |
| Provider Name | Meredith Ann Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275205759 PECOS PAC ID: 3678961307 Enrollment ID: I20211028001615 |
| Provider Name | Heli Ashish Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467866418 PECOS PAC ID: 7810291663 Enrollment ID: I20220915000052 |
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Gaston Family Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 137 Stowe Rd, Gastonia, NC 28056 Phone: 704-836-9112 Fax: 704-824-4715 | |
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