Gateway Iom, LLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

GATEWAY IOM, LLC

Practice address

4579 Laclede Ave # 446
Saint Louis, MO 63108-2103

Phone

(314) 627-1335

NPI assigned

May 6, 2016

Organization subpart

No

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

Authorized official

Name

Josue Gabriel, M.D.

Title

Managing Member

Phone

(464) 627-1335

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1467808667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 LACLEDE AVE # 446",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 LACLEDE AVE # 446",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082103",
            "telephone_number": "314-627-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY IOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "JOSUE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "464-627-1335",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gateway Health Care Inc
• Gateway Health Medical Group PC
• Gateway Home Health Care LLC
• Gateway Hospitalist PC
• Gateway Housing Foundation
• Gateway Low Vision LLC
• Gateway Mental Wellness
• Gateway Nephrology Corp
• Gateway Optical Service Inc.
• Gateway Psychiatric Group, LLC

• Clinical Neurophysiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Neurophysiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.