Organization Active NPI

Gateway Healthcare

  • General Practice Physician
  • Midland, MI
National Provider Identifier
1508519414
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GATEWAY HEALTHCARE
Practice address
1549 Washington St
Midland, MI 48640-5685
Phone
(989) 259-1000
Fax
(989) 402-0097
NPI assigned
Jan 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
James Mier
Title
Clinic Director
Phone
(989) 259-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1549 Washington St
Midland, MI 48640-5685

Mailing address

1549 Washington St
Midland, MI 48640-5685
Phone (989) 259-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220304001151 MI Part B Supplier - Clinic/Group Practice 4284028481 Receives reassigned benefits from 5 practitioners
Practice locations: Midland, MI

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
23D2251885Gateway Healthcare1549 Washington Street, Midland, MI 48640Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1508519414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1549 WASHINGTON ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486405685",
            "telephone_number": "989-259-1000",
            "fax_number": "989-402-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 WASHINGTON ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486405685",
            "telephone_number": "989-259-1000",
            "fax_number": "989-402-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "MIER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "989-259-1000"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.