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1306143219 NPI number — ALEXIS PIERINO GOSS PA-C

NPI Number: 1306143219
Health Care Provider/Practitioner: ALEXIS PIERINO GOSS PA-C

Information about “1306143219” NPI (ALEXIS PIERINO GOSS PA-C) exists in 1306143219 in HTML format HTML  |  1306143219 in plain Text format TXT  |  1306143219 in PDF (Portable Document Format) PDF  |  1306143219 in an XML format XML  formats.

NPI Number : 1306143219 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306143219",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GOSS",
    "FirstName": "ALEXIS",
    "MiddleName": "PIERINO",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2000 PERIMETER PARK DR STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MORRISVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27560-8442",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "101 HEART DRIVE MAILSTOP 654",
    "SecondLinePracticeLocationAddress": "ECU PHYSICIANS FAMILY MEDICINE",
    "PracticeLocationAddressCityName": "GREENVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27834-4300",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "252-744-4611",
    "PracticeLocationAddressFaxNumber": "252-744-2056",
    "EnumerationDate": "02/13/2011",
    "LastUpdateDate": "08/23/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "001002753",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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