Gaston Family Health Services, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GASTON FAMILY HEALTH SERVICES, INC

Doing business as

Kintegra Family Dentistry - Hickory

Practice address

3070 11TH Avenue Dr SE
Hickory, NC 28602-8336

Phone

(828) 695-5778

Fax

(704) 671-1404

NPI assigned

Jan 13, 2020

Last updated

Jan 13, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

GASTON FAMILY HEALTH SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Sharmila Alexander Anderson

Title

Business Services Administrator

Phone

(704) 874-1907

Specialties & licenses 1

Addresses

Other names 1

• Kintegra Family Dentistry - Hickory Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538709100. Details of each certification follow.

• CCN 341152 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341152

Legal name

KINTEGRA FAMILY DENTISTRY - HICKORY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 17, 2020

Last certification

Mar 17, 2020

Ownership / control type

For profit – partnership

Facility address

3070 11TH Avenue Drive SE
Hickory, NC 28602

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

CLIA laboratory certificates

Part of

Gaston Family Health SE

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1538709100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 W HUDSON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280526430",
            "telephone_number": "704-853-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 11TH AVENUE DR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028336",
            "telephone_number": "828-695-5778",
            "fax_number": "704-671-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "BUSINESS SERVICES ADMINISTRATOR",
        "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 Dentistry - Hickory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffery Scott Garmon, C.PED
• Betty H Gast, LPT
• Gaston Family Health Services Inc (Kintegra at Snow Creek Elementary)
• Gaston Family Health Services, Inc (Kintegra Family Medicine - Hickory)
• Gaston Family Health Services, Inc (Kintegra at Ray Childers Elementary)
• Gaston Family Health Services, Inc (Kintegra at Clyde Campbell Elementary)
• Gaston Family Health Services, Inc (Kintegra at Mountain View Elementary)
• Gaston Family Health Services, Inc. (Kintegra at Southwest Elementary)
• Gaston Family Health Services, Inc. (Kintegra at Catawba County Public Health)
• Gaston Family Health Services, Inc. (Kintegra at Challenger High)

• Federally Qualified Health Center (FQHC) in Hickory, NC
• Providers in Hickory, NC by specialty
• Federally Qualified Health Center (FQHC) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.