NPIMap

Organization Active NPI

Gaston Family Health Services, Inc.

Doing business as Kintegra at Gaston Early College of Medical Sciences

  • Federally Qualified Health Center (FQHC)
  • Dallas, NC
National Provider Identifier
1023689304
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GASTON FAMILY HEALTH SERVICES, INC.
Doing business as
Kintegra at Gaston Early College of Medical Sciences
Practice address
201 Highway 321 S
Dallas, NC 28034-1402
Phone
(704) 922-6200
NPI assigned
Jul 7, 2021
Last updated
Jul 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GASTON FAMILY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sharmila Alexander Anderson
Title
Medical Billing & Coding Supervisor
Phone
(704) 874-1907

Specialties & licenses 1

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

Addresses

Primary practice location

201 Highway 321 S
Dallas, NC 28034-1402

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358

Other names 1

  • Kintegra at Gaston Early College of Medical Sciences Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023689304. Details of each certification follow.

  • CCN 861829 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 861829

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
KINTEGRA AT GASTON EARLY COLLEGE OF MEDICALSCIENCE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 7, 2021
Last certification
Oct 7, 2021
Ownership / control type
For profit – corporation
Facility address
201 Highway 321 S
Dallas, NC 28034

National Provider Directory

National Provider Directory
Part of
Gaston Family Health SE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1023689304",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HIGHWAY 321 S",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341402",
            "telephone_number": "704-922-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "MEDICAL BILLING & CODING SUPERVISOR",
        "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 Gaston Early College of Medical Sciences",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kintegra at Gaston Early College of Medical Sciences",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, NC

Sources for this page

Verify at the official NPI Registry.