NPIMap

Organization Active NPI

Hancock Health Gateway Services, Inc.

Doing business as Gateway Immediate Care

  • Family Medicine Physician
  • Greenfield, IN
National Provider Identifier
1649749052
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HANCOCK HEALTH GATEWAY SERVICES, INC.
Doing business as
Gateway Immediate Care
Practice address
6189 John L. Modglin Dr
Suite 101
Greenfield, IN 46140-9364
Phone
(317) 866-7300
NPI assigned
Nov 14, 2018
Last updated
Jun 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Authorized official

Name
Steven Long
Title
Ceo
Phone
(317) 468-4412

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

6189 John L. Modglin Dr
Suite 101
Greenfield, IN 46140-9364

Mailing address

6189 W John L. Modglin Dr
Suite 101
Greenfield, IN 46140-9364
Phone (317) 866-7300

Other names 1

  • Gateway Immediate Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190920001858 IN Part B Supplier - Clinic/Group Practice 9436489234 Receives reassigned benefits from 29 practitioners
Practice locations: Greenfield, IN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
15D2171460Gateway Immediate Care6189 John L Modglin Dr Suite 101, Greenfield, IN 46140Certificate of waiverAug 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Gateway Imaging3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6189 W John L Modglin Dr
Ste 101
Greenfield, IN 46140
Phone (317) 866-7300

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1649749052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6189 W JOHN L. MODGLIN DR",
            "address_2": "SUITE 101",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461409364",
            "telephone_number": "317-866-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6189 JOHN L. MODGLIN DR",
            "address_2": "SUITE 101",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461409364",
            "telephone_number": "317-866-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK HEALTH GATEWAY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-468-4412"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.