NPIMap

Organization Active NPI

Gateway Community Health Centers, Inc.

Doing business as Gateway Community Health

  • Federally Qualified Health Center (FQHC)
  • Elizabeth City, NC
National Provider Identifier
1487936514
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GATEWAY COMMUNITY HEALTH CENTERS, INC.
Doing business as
Gateway Community Health
Practice address
201 E Ehringhaus St
Elizabeth City, NC 27909-4941
Phone
(252) 333-1047
Fax
(252) 384-2652
NPI assigned
Sep 14, 2011
Last updated
Mar 26, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY COMMUNITY HEALTH CENTERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Rose Turner
Title
Ceo
Phone
(252) 506-7000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

201 E Ehringhaus St
Elizabeth City, NC 27909-4941

Mailing address

PO Box 297
Gatesville, NC 27938-0297
Phone (252) 357-1226

Other names 1

  • Gateway Community Health Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140828002335 NC Part A Provider - Federally Qualified Health Center (FQHC) 9234356015 Practice locations: Elizabeth City, NC
O20160120001420 NC Part B Supplier - Clinic/Group Practice 9234356015 Receives reassigned benefits from 6 practitioners
Practice locations: Elizabeth City, NC; Gatesville, NC; Tyner, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487936514. Details of each certification follow.

Federally qualified health center certification: CCN 341972

Legal name
GATEWAY COMMUNITY HEALTH CENTERS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 6, 2012
Last certification
Apr 6, 2012
Ownership / control type
For profit – corporation
Most recent change of ownership
Jun 1, 2014 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Dec 8, 2010 in NC
Enrollment address
1134 North Road Street
Elizabeth City, NC 27909-3322

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Gateway Community Health Centers Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Judith Aguilar Individual Corporate OfficerTreasurer-Board of Director Jun 1, 2014
Richard Ochoa Individual Corporate DirectorMember-Board of Director Jun 1, 2014
Jennifer Greene Individual Corporate OfficerChair-Board of Director Jun 1, 2014
Rose M Turner Individual Corporate OfficerCeo Jun 1, 2014
W-2 Managing EmployeeCeo Jun 1, 2014
Operational/Managerial ControlCeo Jun 1, 2014
Gateway Community Health Centers, Inc. Organization, Gatesville, NC Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2014 100%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gateway Community Health Centers, Inc.Gatesville, NC, CCN 341978 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2014
Gateway Community Health Centers, Inc.Tyner, NC, CCN 341979 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1487936514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "GATESVILLE",
            "state": "NC",
            "postal_code": "279380297",
            "telephone_number": "252-357-1226",
            "fax_number": "252-357-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E EHRINGHAUS ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279094941",
            "telephone_number": "252-333-1047",
            "fax_number": "252-384-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY COMMUNITY HEALTH CENTERS, INC",
        "enumeration_date": "2011-09-14",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-506-7000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Community Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gateway Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth City, NC

Sources for this page

Verify at the official NPI Registry.