Gateway Stem Academy

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

GATEWAY STEM ACADEMY

Practice address

12119 16TH Ave S
Burnsville, MN 55337-2982

Phone

(952) 206-4050

NPI assigned

Dec 10, 2018

Last updated

Dec 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Abdiaziz S Farah

Title

Director

Phone

(952) 206-4050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1174094601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12119 16TH AVE S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372982",
            "telephone_number": "952-206-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12119 16TH AVE S",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372982",
            "telephone_number": "952-206-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY STEM ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "ABDIAZIZ",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-206-4050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndzeahia Amari Gardner
• Brenda Garrett-Johnson, PT
• Karen Lynn Garrison, COTA
• Michael James Gates, MD
• Gateway Health Services Inc (Gateway Health Services)
• Miranda Lynn Gaulke, PHARM.D.
• Elizabeth Gross Gavin, M.D.
• John Gawboy
• John S Gay, MD
• Gregory P Gazzillo, M.D.

• Local Education Agency (LEA) in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Local Education Agency (LEA) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.