1184987877 NPI number — COLIN HAYES GAGE PA-C

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184987877 NPI number — COLIN HAYES GAGE PA-C

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GAGE

Provider First Name:

COLIN

Provider Middle Name:

HAYES

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

PA-C

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1184987877

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/08/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

10900 WORLD TRADE BLVD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

RALEIGH

Provider Business Mailing Address State Name:

NC

Provider Business Mailing Address Postal Code:

27617-4202

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

630-740-0574

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

6402 MCCRIMMON PKWY STE 100

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MORRISVILLE

Provider Business Practice Location Address State Name:

NC

Provider Business Practice Location Address Postal Code:

27560-8139

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

919-655-1000

Provider Business Practice Location Address Fax Number:

919-655-1010

Provider Enumeration Date:

06/19/2012

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 363A00000X , with the licence number:  0010-04941 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 461555 . This is a "GROUP MEDICARE DME #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: CD28777 . This is a "GROUP MEDICARE RAILROAD #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 20076508 . This is a "GROUP SELECT HEALTH DME #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 1225006760 . This is a "GROUP NPI #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 1326287434 . This is a "GROUP MEDICARE DME NPI #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: PA0971 . This is a "GROUP MEDICAID #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 20000499 . This is a "GROUP SELECT HEALTH PROVIDER #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 57-0634057 . This is a "GROUP TAX ID #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 1701 . This is a "GROUP MEDICARE PIN #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
• Identifier: 042299001 . This is a "GROUP DMERC #" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".