NPIMap

Organization Active NPI

Gateway Urgent Care, LLC

  • Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1124325865
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
GATEWAY URGENT CARE, LLC
Practice address
3245 Mount Moriah Ave
Suite 10
Owensboro, KY 42303-7834
Phone
(270) 570-7500
Fax
(270) 689-0051
NPI assigned
Feb 15, 2011
Last updated
Aug 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Authorized official

Name
Mr. John McNulty
Title
Part Owner
Phone
(270) 570-7500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

3245 Mount Moriah Ave
Suite 10
Owensboro, KY 42303-7834

Mailing address

3245 Mount Moriah Ave
Suite 10
Owensboro, KY 42303-7834
Phone (270) 663-0955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310000481 KY Part B Supplier - Clinic/Group Practice 6406038579 Receives reassigned benefits from 17 practitioners
Practice locations: Owensboro, KY

National Provider Directory

National Provider Directory

Locations

2804 Frederica St
Owensboro, KY 42301

2804 Frederica St
Ste 1
Owensboro, KY 42301
Phone (270) 240-3633

3245 Mount Moriah Ave
Owensboro, KY 42303

3245 Mount Moriah Ave
Ste 10
Owensboro, KY 42303
Phone (270) 663-0955

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1124325865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 MOUNT MORIAH AVE",
            "address_2": "SUITE 10",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037834",
            "telephone_number": "270-663-0955",
            "fax_number": "270-663-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 MOUNT MORIAH AVE",
            "address_2": "SUITE 10",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037834",
            "telephone_number": "270-570-7500",
            "fax_number": "270-689-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "270-570-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.