Coastal Gateway Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COASTAL GATEWAY HEALTH CENTER

Practice address

2584 State Highway 124
Winnie, TX 77665-7889

Phone

(409) 296-4444

NPI assigned

Sep 23, 2022

Organization subpart

No

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

Authorized official

Name

Kaley Smith, MHA

Title

Chief Executive Officer

Phone

(409) 296-4444

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFIICD

Practitioners 3

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

• Taylor Brooke Ledoux

  • Family Nurse Practitioner
  • Winnie, TX
  • NPI 1669347365
  Medicare reassignment Care Compare group NPD
• Michael Lyons, DO

  • Family Medicine Physician
  • Winnie, TX
  • NPI 1881688042
  Medicare reassignment Care Compare group NPD
• Kacey White Flores, PA-C

  • Physician Assistant
  • Winnie, TX
  • NPI 1760720049
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1033832167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 STATE HIGHWAY 124",
            "city": "WINNIE",
            "state": "TX",
            "postal_code": "776657889",
            "telephone_number": "409-296-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 STATE HIGHWAY 124",
            "city": "WINNIE",
            "state": "TX",
            "postal_code": "776657889",
            "telephone_number": "409-296-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL GATEWAY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KALEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "409-296-4444",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookshire Brothers Inc
• William Clay Brown, MD
• Margaret Deanna Campbell
• Chambers County
• Chambers County Public Hospital District #1
• Martha Davis, P.A.
• Daniel Sean Degarmo, RN, ENP
• East Chambers Isd
• Vannessa Veronique Evans, NP
• Michael Dennis Fahey, DDS

• Federally Qualified Health Center (FQHC) in Winnie, TX
• Providers in Winnie, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.