NPIMap

Organization Active NPI

Gaston Family Health Services, Inc.

Doing business as Kintegra at South Newton Elementary

  • Federally Qualified Health Center (FQHC)
  • Newton, NC
National Provider Identifier
1578043113
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GASTON FAMILY HEALTH SERVICES, INC.
Doing business as
Kintegra at South Newton Elementary
Practice address
306 W I St
Newton, NC 28658-3534
Phone
(828) 464-4061
Fax
(828) 464-7528
NPI assigned
Aug 14, 2018
Last updated
Jan 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
GASTON FAMILY HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

306 W I St
Newton, NC 28658-3534

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1907

Other names 1

  • Kintegra at South Newton Elementary Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040712000470 NC Part B Supplier - Clinic/Group Practice 5496733925 Receives reassigned benefits from 325 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thomasville, NC; Statesville, NC; Shelby, NC; Newton, NC; Mocksville, NC; Lincolnton, NC; Asheboro, NC; Lexington, NC…
O20200327002773 NC Part A Provider - Federally Qualified Health Center (FQHC) 5496733925 Practice locations: Newton, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578043113. Details of each certification follow.

Federally qualified health center certification: CCN 341145

Legal name
GASTON FAMILY HEALTH SERVICES INC
Doing business as
KINTEGRA AT SOUTH NEWTON ELEMENTARY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 27, 2020
Last certification
Mar 27, 2020
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 1991 in NC
Enrollment address
306 W I St
Newton, NC 28658-3534

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Part of
Gaston Family Health SVCS

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Shirley Stowe Individual Corporate DirectorBoard Member Jul 21, 2014
Harold Thornburg Individual Corporate DirectorBoard Member Jan 23, 2019
Sharmila Anderson Individual W-2 Managing Employee Jul 2, 2012
Jacobus Dodoo Individual Corporate DirectorBoard Member Jul 21, 2014
Charles Luther Moore Individual Corporate DirectorBoard Member Sep 28, 2022
John Herrera Individual Corporate DirectorBoard Member Jul 21, 2014
James Hodges Individual Corporate DirectorBoard Member Jul 21, 2014
Betty Worthy Individual Corporate DirectorBoard Member Sep 26, 2018
Theresa Matthews Individual Corporate DirectorBoard Member Jul 21, 2014
Ralph Luther Bentley Individual Corporate DirectorBoard Member Jul 1, 2021
Robert Jones Individual Corporate DirectorBoard Member Jul 21, 2014
Jennifer Foster McCracken Individual Corporate DirectorBoard Member Jul 24, 2019
Robert Spencer Individual Corporate Officer Jan 8, 1996
Corporate Director Jan 8, 1996
W-2 Managing Employee Jan 8, 1996
Operational/Managerial Control Jan 8, 1996
James Macomson Individual Corporate DirectorBoard Member Nov 28, 2018
Ami Robinson Steele Individual Corporate DirectorBoard Member Apr 27, 2022
Douglas Scarborough Individual Corporate DirectorBoard Member Oct 26, 2022
Brian McGinnis Individual Corporate DirectorBoard Member Jul 21, 2014
Ronald Worley Individual Corporate DirectorBoard Member Nov 28, 2018
Kristin Hayes Monza Individual Corporate DirectorBoard Member Apr 27, 2022
Michele Knapp Individual Corporate DirectorBoard Member May 26, 2021
Paula Ratchford Black Individual Corporate DirectorBoard Member Feb 25, 2021
Phillip Lee Hinely Individual Corporate DirectorBoard Member Jul 21, 2014
Ramona Neal Individual Corporate DirectorBoard Member Jul 21, 2014

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1578043113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1907",
            "fax_number": "704-874-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W I ST",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286583534",
            "telephone_number": "828-464-4061",
            "fax_number": "828-464-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra at South Newton Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton, NC

Sources for this page

Verify at the official NPI Registry.