JONATHAN LABAYO DESAMERO FNP NPI 1003804972

NPI Information

  • NPI: 1003804972
  • Provider Name: JONATHAN LABAYO DESAMERO, FNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3715 UNION RD
    GASTONIA, NC
    ZIP 28056
  • Phone: (704) 854-8202

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NPI Details

Jonathan Labayo Desamero, FNP is a family nurse practitioner in Gastonia, NC with 24 years of experience. Jonathan Labayo Desamero, FNP NPI is 1003804972. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3715 UNION RD
GASTONIA, NC
ZIP 28056-044
Phone: (704) 854-8202

The NPI 1003804972 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/13/2005 and was last updated on 7/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner201824NORTH CAROLINANo
2363LF0000XNurse PractitionerFamily201824NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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