Gaston Family Health Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GASTON FAMILY HEALTH SERVICES, INC.

Practice address

451 Catawba Valley Blvd
Hickory, NC 28602-9631

Phone

(828) 328-2289

NPI assigned

Jul 20, 2020

Organization subpart

Yes

Parent organization

GASTON FAMILY HEALTH SERVICES, INC.As 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 at Grandview Middle Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Federally qualified health center certification: CCN 341163

Legal name

GASTON FAMILY HEALTH SERVICES INC

Doing business as

KINTEGRA AT GRANDVIEW MIDDLE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 24, 2020

Last certification

Nov 24, 2020

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jun 28, 1991 in NC

Enrollment address

451 Catawba Valley Blvd
Hickory, NC 28602-9631

Part of

Gaston Family Health SE

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ralph L Bentley, M.D.

  • Pediatrics Physician
  • Statesville, NC
  • NPI 1912999681

  Corporate Director

  CMS ownership
• Kristin Hayes Monza, NP

  • Nurse Practitioner
  • Charlotte, NC
  • NPI 1437692035

  Corporate Director

  CMS ownership

Practitioners 3

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

• Jessica Lorene Debnam, LCSW

  • Clinical Social Worker
  • Hickory, NC
  • NPI 1124746979
  NPD
• Cara Reynolds Noblitt, LCSW

  • Clinical Social Worker
  • Hickory, NC
  • NPI 1538831482
  NPD
• Brittany Nicole Collins, LCSW

  • Clinical Social Worker
  • Hickory, NC
  • NPI 1750865648
  NPD (past)

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1124636873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CATAWBA VALLEY BLVD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029631",
            "telephone_number": "828-328-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra at Grandview Middle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kintegra at Grandview Middle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gaston Family Health Services, Inc
• Gaston Family Health Services, Inc
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.
• Gaston Family Health Services, Inc.

• Federally Qualified Health Center (FQHC) in Hickory, NC
• Providers in Hickory, 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 Aug 20, 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.