NPIMap

Organization Active NPI

Gateway Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tyner, NC
National Provider Identifier
1679853642
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GATEWAY COMMUNITY HEALTH CENTERS, INC.
Doing business as
Gateway Community Health Centers, Inc
Practice address
2869 Virginia Rd
Tyner, NC 27980-9777
Phone
(252) 506-7000
Fax
(252) 357-1236
NPI assigned
Aug 23, 2011
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY COMMUNITY HEALTH CENTERS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Rose Turner
Title
Ceo
Phone
(252) 357-1226

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2869 Virginia Rd
Tyner, NC 27980-9777

Mailing address

PO Box 297
501 Main Street
Gatesville, NC 27938-9424
Phone (252) 357-1226

Other names 1

  • Gateway Community Health Centers, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140828002184 NC Part A Provider - Federally Qualified Health Center (FQHC) 9234356015 Practice locations: Tyner, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679853642. Details of each certification follow.

Federally qualified health center certification: CCN 341979

Legal name
GATEWAY COMMUNITY HEALTH CENTERS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2012
Last certification
Jul 25, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 8, 2010 in NC
Enrollment address
2689 Virginia Road
Tyner, NC 27980-9777

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Gateway Community Health Centers Inc8 organizations share this tax ID, including this one
Part of
Gateway Community Health Centers Inc

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Taiesha Moore Individual Corporate OfficerBoard Member Jan 1, 2020
Sharonita Cousin Individual Corporate OfficerBoard Member Jan 1, 2020
Richard Ochoa Individual Corporate DirectorMember Board of Directors Jun 1, 2014
Althea Riddick Individual Corporate OfficerVice Chairman Jan 1, 2020
Jennifer Greene Individual Corporate OfficerChair-Board of Director Jun 1, 2014
Rose M Turner Individual Corporate OfficerCeo Jun 1, 2014
W-2 Managing EmployeeCeo Jun 1, 2014
Operational/Managerial ControlCeo Jun 1, 2014
Vincent Jones Individual Corporate OfficerFinancial Chairman Jan 1, 2020
Gateway Community Health Centers, Inc. Organization, Tyner, NC 5% Or Greater Indirect Ownership Interest Jun 1, 2014 100%
Junior James Individual Corporate OfficerBoard Member Jan 1, 2020

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gateway Community Health Centers, Inc.Gatesville, NC, CCN 341978 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2014
Gateway Community Health Centers, Inc.Elizabeth City, NC, CCN 341972 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1679853642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "address_2": "501 MAIN STREET",
            "city": "GATESVILLE",
            "state": "NC",
            "postal_code": "279389424",
            "telephone_number": "252-357-1226",
            "fax_number": "252-357-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2869 VIRGINIA RD",
            "city": "TYNER",
            "state": "NC",
            "postal_code": "279809777",
            "telephone_number": "252-506-7000",
            "fax_number": "252-357-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY COMMUNITY HEALTH CENTERS, INC",
        "enumeration_date": "2011-08-23",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "252-357-1226"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Community Health Centers, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyner, NC

Sources for this page

Verify at the official NPI Registry.