Gaston Family Health Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GASTON FAMILY HEALTH SERVICES, INC

Doing business as

Kintegra Family Dentistry - Lexington

Practice address

32 Kirkwood Ave
Lexington, NC 27292-4024

Phone

(336) 243-3201

Fax

(704) 671-1404

NPI assigned

Jan 10, 2020

Last updated

Feb 18, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

GASTON FAMILY HEALTH SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Sharmila Alexander Anderson

Title

Business Services Administrator

Phone

(704) 874-1907

Specialties & licenses 1

Addresses

Other names 1

• Kintegra Family Dentistry - Lexington Doing business as

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 1053951756. Details of each certification follow.

• CCN 341137 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341137

Legal name

KINTEGRA FAMILY DENTISTRY - LEXINGTON

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 20, 2020

Last certification

Mar 20, 2020

Ownership / control type

For profit – partnership

Facility address

32 Kirkwood Avenue
Lexington, NC 27292

Part of

Gaston Family Health SE

Locations

Practitioners 2

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.

• Alyssa Works Izic, DDS

  • Dentist
  • Lexington, NC
  • NPI 1851743736
  NPD (past)
• Jessica Davida Shamberger, DMD

  • General Practice Dentistry
  • Gastonia, NC
  • NPI 1790344679
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1053951756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 W HUDSON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280526430",
            "telephone_number": "704-853-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 KIRKWOOD AVE",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272924024",
            "telephone_number": "336-243-3201",
            "fax_number": "704-671-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra Family Dentistry - Lexington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula Gangopadhyay, DPM
• Faith Lockett Gardner, M.D.
• Kevin Gardner, PHARMD
• Garrett Werkman DDS PLLC
• Gaston Family Health Services Inc (Davidson Health Services Pharmacy)
• Gaston Family Health Services, Inc. (Kintegra Family Medicine - Lexington)
• Gaston Family Health Services, Inc. (Kintegra Mobile Dentistry Unit East)
• Gaston Family Health Services, Inc. (Kintegra Mobile Health)
• Emily Danielle Gates, LCSW
• Jennifer Gates, MS, NCC, LPC

• Federally Qualified Health Center (FQHC) in Lexington, NC
• Providers in Lexington, NC by specialty
• Federally Qualified Health Center (FQHC) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.