NPIMap

Gaston Family Health Services, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Newton, NC

NPI 1023598570 · NPPES record last updated Jan 15, 2020

Key facts

NPI
1023598570
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
GASTON FAMILY HEALTH SERVICES, INC.
Practice address
221 W 26TH St
Newton, NC 28658-2821
Phone
(828) 464-2631
Fax
(828) 466-5598
NPI assigned
Aug 15, 2018
Organization subpart
Yes
Parent organization (as reported)
GASTON FAMILY HEALTH SERVICES, INC.

Authorized official

Name
Sharmila Alexander Anderson
Title
Business Services Administrator
Phone
(704) 874-1907

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

Federally qualified health center certification: CCN 341151

Legal name
GASTON FAMILY HEALTH SERVICES INC
Doing business as
KINTEGRA AT NORTH NEWTON ELEMENTARY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 27, 2020
Last certification
Mar 27, 2020
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Jun 28, 1991 in NC
Enrollment address
221 W 26TH St
Newton, NC 28658-2821

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shirley Stowe
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Harold Thornburg
Individual 		Corporate Director
Board Member		 Jan 23, 2019
Sharmila Anderson
Individual 		W-2 Managing Employee Jul 2, 2012
Jacobus Dodoo
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Charles Luther Moore
Individual 		Corporate Director
Board Member		 Sep 28, 2022
John Herrera
Individual 		Corporate Director
Board Member		 Jul 21, 2014
James Hodges
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Betty Worthy
Individual 		Corporate Director
Board Member		 Sep 26, 2018
Theresa Matthews
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Ralph Luther Bentley
Individual 		Corporate Director
Board Member		 Jul 1, 2021
Robert Jones
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Jennifer Foster McCracken
Individual 		Corporate Director
Board Member		 Jul 24, 2019
Robert Spencer
Individual 		Corporate Officer Jan 8, 1996
Corporate Director Jan 8, 1996
W-2 Managing Employee Jan 8, 1996
Operational/Managerial Control Jan 8, 1996
James Macomson
Individual 		Corporate Director
Board Member		 Nov 28, 2018
Ami Robinson Steele
Individual 		Corporate Director
Board Member		 Apr 27, 2022
Douglas Scarborough
Individual 		Corporate Director
Board Member		 Oct 26, 2022
Brian McGinnis
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Ronald Worley
Individual 		Corporate Director
Board Member		 Nov 28, 2018
Kristin Hayes Monza
Individual 		Corporate Director
Board Member		 Apr 27, 2022
Michele Knapp
Individual 		Corporate Director
Board Member		 May 26, 2021
Paula Ratchford Black
Individual 		Corporate Director
Board Member		 Feb 25, 2021
Phillip Lee Hinely
Individual 		Corporate Director
Board Member		 Jul 21, 2014
Ramona Neal
Individual 		Corporate Director
Board Member		 Jul 21, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040712000470 NC Part B Supplier - Clinic/Group Practice 5496733925 Receives reassigned benefits from 325 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thomasville, NC; Statesville, NC; Shelby, NC; Newton, NC; Mocksville, NC; Lincolnton, NC; Asheboro, NC; Lexington, NC…
O20200327002475 NC Part a Provider - Federally Qualified Health Center (FQHC) 5496733925 Practice locations: Newton, NC

National Provider Directory

Part of
Gaston Family Health SE

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

221 W 26TH St
Newton, NC 28658-2821

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1907

Other names

  • Kintegra at North Newton Elementary Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2020.

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1023598570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W 26TH ST",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286582821",
            "telephone_number": "828-464-2631",
            "fax_number": "828-466-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2018-08-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "BUSINESS SERVICES ADMINISTRATOR",
        "authorized_official_telephone_number": "704-874-1907"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra at North Newton Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton, NC

All providers in Newton, NC · Federally Qualified Health Center (FQHC) in North Carolina

Sources for this page

Verify at the official NPI Registry.