NPIMap

Organization Active NPI

Gateway Gastroenterology Inc

  • Specialist
  • Chesterfield, MO
National Provider Identifier
1043250400
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36578 Issued in MO
Legal business name
GATEWAY GASTROENTEROLOGY INC
Practice address
17298 N Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456
Phone
(314) 529-4900
Fax
(314) 434-2679
NPI assigned
Jun 7, 2006
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Mrs. Jackie Lynn Raspberry
Title
Office Manager
Phone
(314) 529-4925

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 36578 MO Primary

Addresses

Primary practice location

17298 N Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456

Mailing address

17298 North Outer 40 Rd Ste 200
Chesterfield, MO 63005-1456
Phone (314) 529-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040909000422 MO Part B Supplier - Clinic/Group Practice 2668448713 Receives reassigned benefits from 25 practitioners
Practice locations: Chesterfield, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0869688Gateway Gastroenterology17298 N Outer 40 Road, Suite 200, Chesterfield, MO 63005ComplianceNov 5, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

121 Saint Lukes Center Dr
Ste 406
Chesterfield, MO 63017
Phone (314) 432-5900

17298 North Outer 40 Rd
Ste 200
Chesterfield, MO 63005
Phone (314) 529-4900

621 S New Ballas Rd
Ste 228A
Saint Louis, MO 63141
Phone (314) 251-4966

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1043250400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17298 NORTH OUTER 40 RD STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051456",
            "telephone_number": "314-529-4900",
            "fax_number": "314-434-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17298 N OUTER 40 RD STE 200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051456",
            "telephone_number": "314-529-4900",
            "fax_number": "314-434-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY GASTROENTEROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "RASPBERRY",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-529-4925",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "36578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.