MEDICARE: CAROLINA SPINE, PAIN AND REHABILITATION PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	020JA	OTHER	NC	BLUECROSS BLUESHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134185184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA SPINE, PAIN AND REHABILITATION PLLC

Provider Business Mailing Address
First Line	:	PO BOX 550700
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28055-0700
Country	:	US
Telephone Number	:	704-864-3300
Fax Number	:	704-864-2002

Provider Business Practice Location Address
First Line	:	900 COX RD
Second Line	:	STE A
City	:	GASTONIA
State	:	NC
Zip	:	28054-3460
Country	:	US
Telephone Number	:	704-864-3300
Fax Number	:	704-864-2002

Authorized Official
Title or Position	:	CEO
Name	:	DR. HERMAN CLARK GORE
Credential	:	MD
Telephone Number	:	704-864-3300

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	12/07/2022

Similar Medicare Providers

1164356168 — SHAMAR CRAIG
Practice Location Address:

900 COX RD
GASTONIA, NC
28054-3460

Practice Phone: 828-455-3446
Practice Fax:

1891758876 — MS. JENNIFER A. DROVIE P.A.
Practice Location Address:

900 COX RD , SUITE A
GASTONIA, NC
28054-3460

Practice Phone: 704-864-3300
Practice Fax: 704-864-2002

1336103365 — DR. HERMAN CLARK GORE M.D.
Practice Location Address:

900 COX RD , SUITE A
GASTONIA, NC
28054-3460

Practice Phone: 704-864-3300
Practice Fax: 704-864-2002

1053400887 — SOUTHERN PULMONARY CENTER, P.A.
Practice Location Address:

900 COX RD , STE B
GASTONIA, NC
28054-3460

Practice Phone: 704-868-3411
Practice Fax: 704-865-9722

1326249327 — ORION IMAGING, LLC
Practice Location Address:

900 COX RD
GASTONIA, NC
28054-3460

Practice Phone: 704-830-1020
Practice Fax: 704-830-1040

1407376718 — NICHOLAS DANIEL SMITH
Practice Location Address:

900 COX RD
GASTONIA, NC
28054-3460

Practice Phone: 828-455-3446
Practice Fax:

Directions to “CAROLINA SPINE, PAIN AND REHABILITATION PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.