NPIMap

Organization Active NPI

Gaston Family Health Services, Inc.

Doing business as Kintegra Family Medicine - Bessemer City - Virginia Ave

  • Federally Qualified Health Center (FQHC)
  • Bessemer City, NC
National Provider Identifier
1285485383
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GASTON FAMILY HEALTH SERVICES, INC.
Doing business as
Kintegra Family Medicine - Bessemer City - Virginia Ave
Practice address
308 E Virginia Ave
Bessemer City, NC 28016
Phone
(704) 629-3465
NPI assigned
Mar 28, 2024
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GASTON FAMILY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Sharmila Alexander Anderson
Title
Revenue Cycle Manager
Phone
(704) 874-1907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

308 E Virginia Ave
Bessemer City, NC 28016

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358

Other names 1

  • Kintegra Family Medicine - Bessemer City - Virginia Ave Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250217003289 NC Part A Provider - Federally Qualified Health Center (FQHC) 5496733925 Practice locations: Bessemer City, NC
O20250502002839 NC Part B Supplier - Pharmacy 5496733925 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, NC; Statesville, NC; Shelby, NC; Lincolnton, NC; Kings Mountain, NC; Gastonia, NC; Asheboro, NC; Charlotte, NC…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285485383. Details of each certification follow.

Federally qualified health center certification: CCN B61062

Legal name
GASTON FAMILY HEALTH SERVICES INC
Doing business as
KINTEGRA FAMILY MEDICINE - BESSEMER CITY - VIRGINIA AV
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 25, 2024
Last certification
Nov 25, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 1991 in NC
Enrollment address
308 E Virginia Ave
Bessemer City, NC 28016-2215

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1048047Kintegra Family Medicine Bessemer City308 E. Virginia Avenue, Bessemer City, NC 28016Certificate of waiverDec 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Gaston Family Health SE264 organizations share this tax ID, including this one
Part of
Gaston Family Health SE

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Shirley Stowe Individual Corporate DirectorBoard Member Jul 21, 2014
Harold Thornburg Individual Corporate DirectorBoard Member Jan 23, 2019
Sharmila Anderson Individual W-2 Managing Employee Jul 2, 2012
Jacobus Dodoo Individual Corporate DirectorBoard Member Jul 21, 2014
Charles Luther Moore Individual Corporate DirectorBoard Member Sep 28, 2022
John Herrera Individual Corporate DirectorBoard Member Jul 21, 2014
Betty Worthy Individual Corporate DirectorBoard Member Sep 26, 2018
Theresa Matthews Individual Corporate DirectorBoard Member Jul 21, 2014
Ralph Luther Bentley Individual Corporate DirectorBoard Member Jul 1, 2021
Robert Jones Individual Corporate DirectorBoard Member Jul 21, 2014
Jennifer Foster McCracken Individual Corporate DirectorBoard Member Jul 24, 2021
Robert Spencer Individual Corporate Officer Jan 8, 1996
Corporate Director Jan 8, 1996
W-2 Managing Employee Jan 8, 1996
Operational/Managerial Control Jan 8, 1996
James Macomson Individual Corporate DirectorBoard Member Nov 28, 2018
Douglas Scarborough Individual Corporate DirectorBoard Member Oct 26, 2022
Brian McGinnis Individual Corporate DirectorBoard Member Jul 21, 2014
Kristin Hayes Monza Individual Corporate DirectorBoard Member Apr 27, 2022
Michele Knapp Individual Corporate DirectorBoard Member May 26, 2021
Paula Ratchford Black Individual Corporate DirectorBoard Member Feb 25, 2021
Phillip Lee Hinely Individual Corporate DirectorBoard Member Jul 21, 2014
Ramona Neal Individual Corporate DirectorBoard Member Jul 21, 2014

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1285485383",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E VIRGINIA AVE",
            "city": "BESSEMER CITY",
            "state": "NC",
            "postal_code": "28016",
            "telephone_number": "704-629-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "704-874-1907"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra Family Medicine - Bessemer City - Virginia Ave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bessemer City, NC

Sources for this page

Verify at the official NPI Registry.