NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Brunswick, GA
National Provider Identifier
1124254321
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
121 Burgess Rd
Brunswick, GA 31523-9311
Phone
(912) 554-8454
Fax
(912) 280-1478
NPI assigned
Jun 3, 2009
Last updated
Nov 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Mrs. Rachel Skinner
Title
Director of Reimbursement
Phone
(912) 554-8498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

121 Burgess Rd
Brunswick, GA 31523-9311

Mailing address

700 Coastal Village Dr
Brunswick, GA 31523-9311
Phone (912) 554-8510

Other names 1

  • Gateway BHS - Glynn Crisis Residential Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000700 GA Part B Supplier - Clinic/Group Practice 3173510237 Receives reassigned benefits from 76 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kingsland, GA; Springfield, GA; Savannah, GA; Hinesville, GA; Brunswick, GA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

124 SW Broad St
Jesup, GA 31545
Phone (912) 280-7023

Practitioners & affiliated clinicians

Practitioners 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1124254321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COASTAL VILLAGE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315239311",
            "telephone_number": "912-554-8510",
            "fax_number": "912-264-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BURGESS RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315239311",
            "telephone_number": "912-554-8454",
            "fax_number": "912-280-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "912-554-8498",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway BHS - Glynn Crisis Residential",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.