NPIMap

Organization Active NPI

Gwent LLC

Doing business as Gateway ENT

  • Otolaryngology Physician
  • Saint Louis, MO
National Provider Identifier
1508494543
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
GWENT LLC
Doing business as
Gateway ENT
Practice address
9701 Landmark Parkway Dr Ste 201
Saint Louis, MO 63127-1665
Phone
(314) 843-3828
Fax
(314) 843-3052
NPI assigned
Mar 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Authorized official

Name
Mr. Scott Hardeman, MDNPI 1770571721
Title
Physician
Phone
(314) 616-1665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

9701 Landmark Parkway Dr Ste 201
Saint Louis, MO 63127-1665

Mailing address

9701 Landmark Parkway Dr Ste 201
Saint Louis, MO 63127-1665
Phone (314) 843-3828

Other names 1

  • Gateway ENT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200619001463 MO Part B Supplier - Clinic/Group Practice 3971925942 Receives reassigned benefits from 16 practitioners
Practice locations: Festus, MO; Saint Louis, MO; Washington, MO

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
26D2178340Gateway ENT, LLC (Gwent LLC)9701 Landmark Parkway Dr # 201, Saint Louis, MO 63127Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Locations

1400 US Highway 61
Ste G40
Crystal Cty, MO 63028
Phone (636) 543-2140

9701 Landmark Parkway Dr
Ste 200
Saint Louis, MO 63127

621 S New Ballas Rd
Ste 622
Saint Louis, MO 63141

12855 N 40 Dr
Ste 230
Saint Louis, MO 63141
Phone (314) 576-3532

1987 Highway a
Ste 210
Washington, MO 63090
Phone (636) 390-2007

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1508494543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 LANDMARK PARKWAY DR STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271665",
            "telephone_number": "314-843-3828",
            "fax_number": "314-843-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 LANDMARK PARKWAY DR STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271665",
            "telephone_number": "314-843-3828",
            "fax_number": "314-843-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "HARDEMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-616-1665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.