NPIMap

Organization Active NPI

Gateway to Success, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Canon City, CO
National Provider Identifier
1093354680
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GATEWAY TO SUCCESS, PC
Practice address
602 Yale PL
Canon City, CO 81212-4611
Phone
(719) 275-2301
Fax
(719) 896-2874
NPI assigned
Dec 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Karen S Morgenthaler, LCSW, LAC, DVCSNPI 1043589823
Title
Executive Director
Phone
(719) 564-5070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

602 Yale PL
Canon City, CO 81212-4611

Mailing address

PO Box 1748
Canon City, CO 81215-1748
Phone (719) 369-2898

Other identifiers 1

IdentifierTypeStateIssuer
9000150357MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180321001712 CO Part B Supplier - Clinic/Group Practice 3173885670 Receives reassigned benefits from 12 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Colorado Springs, CO; Pueblo, CO; Canon City, CO

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gateway to Success PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

602 Yale Pl
Ste 300
Canon City, CO 81212

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1093354680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1748",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812151748",
            "telephone_number": "719-369-2898",
            "fax_number": "719-896-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 YALE PL",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124611",
            "telephone_number": "719-275-2301",
            "fax_number": "719-896-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY TO SUCCESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "MORGENTHALER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-564-5070",
        "authorized_official_credential": "LCSW, LAC, DVCS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150357",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.