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 - Lincolnton

Practice address

111 Doctors Park
Lincolnton, NC 28092

Phone

(704) 735-2230

Fax

(704) 671-1404

NPI assigned

Jan 17, 2020

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 Service Admin

Phone

(704) 874-1907

Specialties & licenses 1

Addresses

Other names 1

• Kintegra Family Dentistry - Lincolnton 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 1568092658. Details of each certification follow.

• CCN 341138 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341138

Legal name

KINTEGRA FAMILY DENTISTRY - LINCOLNTON

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 20, 2020

Last certification

Mar 20, 2020

Ownership / control type

For profit – partnership

Facility address

111 Doctors Park
Lincolnton, NC 28092

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 SVCS

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1568092658",
    "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": "704-735-2230",
            "fax_number": "704-671-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTORS PARK",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "28092",
            "telephone_number": "704-735-2230",
            "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": "2020-01-17",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "BUSINESS SERVICE ADMIN",
        "authorized_official_telephone_number": "704-874-1907"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra Family Dentistry - Lincolnton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alixandra Jillian Garic, MD
• Anna Marie Garris, PA
• Gaston Family Health Services Inc (Kintegra Family Medicine - Lincolnton)
• Gaston Family Health Services, Inc (Kintegra at Lincolnton Middle)
• Gaston Family Health Services, Inc (Kintegra at Pumpkin Center Primary)
• Gaston Family Health Services, Inc (Kintegra at Asbury Academy)
• Gaston Family Health Services, Inc (Kintegra at Pumpkin Center Intermediate)
• Gaston Family Health Services, Inc. (Kintegra Mobile Dentistry-South)
• Gaston Family Health Services, Inc. (Kintegra at S. Ray Lowder Elementary)
• Gaston Family Health Services, Inc. (Kintegra at GE Massey Elementary)

• Federally Qualified Health Center (FQHC) in Lincolnton, NC
• Providers in Lincolnton, 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 Feb 18, 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.