Integra Healthcare Associates

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

INTEGRA HEALTHCARE ASSOCIATES

Practice address

4071 Tates Creek Centre Dr Ste 101
Lexington, KY 40517-3063

Phone

(859) 396-3050

NPI assigned

Nov 23, 2020

Organization subpart

No

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

Authorized official

Name

Alicia O Gatterdam

Title

Member

Phone

(240) 271-8962

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Clayton Phillip Gatterdam IV, PA-C

  • Physician Assistant
  • Lexington, KY
  • NPI 1174890172

  Medical

  NPD

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1134723919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 CLEARWATER WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156000",
            "telephone_number": "859-396-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR STE 101",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173063",
            "telephone_number": "859-396-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA HEALTHCARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "GATTERDAM",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "240-271-8962"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "computer",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4108 Clearwater Way",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405156000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Lexington, KY
• Urgent Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.