Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gavin Blake Vincent, PA-C

Individual provider Physician Assistant · NPI 1134683394

Gavin Blake Vincent, PA-C is a Physician Assistant in Wilmington, North Carolina. Qualified in 2022, 4 years ago. Practices with Mountain State Medical Specialties PLLC, a 38-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

710 Military Cutoff Rd Ste 320
Wilmington, NC 28405-2382
Phone: (910) 256-4350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-16201 (NC)

Record details

NPI number1134683394
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 22, 2019
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mountain State Medical Specialties Pllc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Wilmington