NPIMap

Organization Active NPI

Gateway Direct Primary Care JV LLC

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1285228304
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GATEWAY DIRECT PRIMARY CARE JV LLC
Practice address
4850 Lemay Ferry Rd Ste 115
Saint Louis, MO 63129-1576
Phone
(866) 808-6005
NPI assigned
Mar 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Jill Johnson Patton
Title
Director of Risk Management
Phone
(704) 936-5546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4850 Lemay Ferry Rd Ste 115
Saint Louis, MO 63129-1576

Mailing address

1400 Wewatta St Ste 350
Denver, CO 80202-5553

National Provider Directory

National Provider Directory
Tax ID family
Gateway Direct Primary Care JV LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4850 Lemay Ferry Rd
Ste 115
Saint Louis, MO 63129

4850 Lemay Ferry Rd
Ste 110
Saint Louis, MO 63129

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1285228304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WEWATTA ST STE 350",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802025553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 LEMAY FERRY RD STE 115",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291576",
            "telephone_number": "866-808-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY DIRECT PRIMARY CARE JV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.