NPIMap

Organization Active NPI

Gaston Family Health Services Inc

Doing business as Kintegra Family Medicine - Lincolnton

  • Federally Qualified Health Center (FQHC)
  • Lincolnton, NC
National Provider Identifier
1710209473
Registry record updated May 7, 2021
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 Family Medicine - Lincolnton
Practice address
212 Gamble Dr
Lincolnton, NC 28092-4421
Phone
(704) 735-7145
Fax
(704) 732-7522
NPI assigned
Feb 23, 2010
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GASTON FAMILY HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2021

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 Administrator
Phone
(704) 874-1907

Specialties & licenses 1

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

Addresses

Primary practice location

212 Gamble Dr
Lincolnton, NC 28092-4421

Mailing address

200 E Second Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

Other identifiers 1

IdentifierTypeStateIssuer
344031AMedicaidNC

Other names 1

  • Kintegra Family Medicine - Lincolnton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

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…
O20100325000646 NC Part A Provider - Federally Qualified Health Center (FQHC) 5496733925 Practice locations: Lincolnton, NC
O20250502002839 NC Part B Supplier - Pharmacy 5496733925 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, NC; Statesville, NC; Shelby, NC; Lincolnton, NC; Kings Mountain, NC; Gastonia, NC; Asheboro, NC; Charlotte, NC…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710209473. Details of each certification follow.

Federally qualified health center certification: CCN 341951

Legal name
GASTON FAMILY HEALTH SERVICES INC
Doing business as
KINTEGRA FAMILY MEDICINE - LINCOLNTON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 29, 2010
Last certification
Mar 29, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1989 in NC
Enrollment address
212 Gamble Dr
Lincolnton, NC 28092-4421

Other NPIs on the same Medicare enrollment 27

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

View all 27

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
34D1005995Kintegra Family Medicine - Lincolnton212 Gamble Drive, Lincolnton, NC 28092Certificate of waiverMar 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gaston Family Health SE264 organizations share this tax ID, including this one
Part of
Gaston Family Health SE

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Pepper Younts Individual Corporate Director Oct 1, 2012
Patti West Individual Corporate Director Feb 25, 2010
Shirley Stowe Individual Corporate Director Feb 25, 2010
Sharmila Anderson Individual W-2 Managing EmployeeBusiness Service Administrator Nov 19, 2014
James Hodges Individual Corporate Director Apr 1, 2011
Robert Spencer Individual Contracted Managing Employee Feb 25, 2010
Mark Skillestad Individual Corporate Director Feb 25, 2010

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1710209473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E SECOND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-867-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 GAMBLE DR",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280924421",
            "telephone_number": "704-735-7145",
            "fax_number": "704-732-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES INC",
        "enumeration_date": "2010-02-23",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SHARMILA",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "BUSINESS SERVICE 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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344031A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra Family Medicine - Lincolnton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnton, NC

Sources for this page

Verify at the official NPI Registry.