Missouri Gateway Health, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MISSOURI GATEWAY HEALTH, LLC

Practice address

10900 Nuckols Rd
Ste 110
Glen Allen, VA 23060-9276

Phone

(804) 396-6412

Fax

(804) 482-2756

NPI assigned

Feb 22, 2017

Organization subpart

Yes

Parent organization

ALLYALIGN HEALTH, INCAs reported in NPPES

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

Authorized official

Name

Kenneth Bratton

Title

Coo

Phone

(804) 396-6412

Specialties & licenses 2

Addresses

Part of

Allyalign Health Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Allyalign Health, Inc.

  • Nurse Practitioner
  • Glen Allen, VA
  • NPI 1053715615
  NPPES parent name

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1073052114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD",
            "address_2": "SUITE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609276",
            "telephone_number": "804-396-6412",
            "fax_number": "804-482-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD",
            "address_2": "STE 110",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609276",
            "telephone_number": "804-396-6412",
            "fax_number": "804-482-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI GATEWAY HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLYALIGN HEALTH, INC",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "BRATTON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "804-396-6412"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Hearts
• Mindful Paths Psychiatric Services (Mindful Paths Psychiatry)
• Peter V Minneci, MD
• Miraja MD PA Inc
• Tyler Jakob Miranda
• MJ Babik DDS and Associates LTD (Crossridge Family and Cosmetic Dentistry)
• Stephanie A Mock, CPHT
• Mohammad S Siddiqui MD Inc
• Karolina Mohler, APRN
• Ali A Mollah, M.D.

• Nurse Practitioner in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.