Gateway Digestive and Liver Specialists, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

107492 Issued in MO

Legal business name

GATEWAY DIGESTIVE AND LIVER SPECIALISTS, LLC

Practice address

4510 Delmar Blvd
Saint Louis, MO 63108-1702

Phone

(314) 454-6903

Fax

(314) 454-6652

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rachel A Montemayor

Title

Office Manager

Phone

(314) 454-6903

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1265566780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081702",
            "telephone_number": "314-454-6903",
            "fax_number": "314-454-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081702",
            "telephone_number": "314-454-6903",
            "fax_number": "314-454-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DIGESTIVE AND LIVER SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "MONTEMAYOR",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-454-6903",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "107492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208107912",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC2409",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.