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 at Jenkins Elementary

Practice address

3750 N Center St
Hickory, NC 28601-8089

Phone

(828) 327-3590

Fax

(828) 327-3491

NPI assigned

Jun 17, 2019

Last updated

Oct 5, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

GASTON FAMILY HEALTH SERVICES, INC.As 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 Administrator

Phone

(704) 874-1907

Specialties & licenses 1

Addresses

Other names 1

• Kintegra at Jenkins Elementary Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780244376. Details of each certification follow.

• CCN 341134 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 341134

Legal name

GASTON FAMILY HEALTH SERVICES INC

Doing business as

KINTEGRA AT JENKINS ELEMENTARY

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 24, 2020

Last certification

Feb 24, 2020

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jun 28, 1991 in NC

Enrollment address

3750 N Center St
Hickory, NC 28601-8089

Part of

Gaston Family Health SE

All disclosed owners & managing parties 17

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

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1780244376",
    "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": "704-874-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 N CENTER ST",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286018089",
            "telephone_number": "828-327-3590",
            "fax_number": "828-327-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GASTON FAMILY HEALTH SERVICES, INC.",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintegra at Jenkins Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gaston Family Health Services, Inc. (Kintegra at Catawba Valley Community College)
• Gaston Family Health Services, Inc. (Kintegra at St. Stephens High)
• Gaston Family Health Services, Inc. (Kintegra at Hickory High)
• Gaston Family Health Services, Inc. (Kintegra at Oakwood Elementary)
• Gaston Family Health Services, Inc. (Kintegra at Catawba Women's Center)
• Gaston Family Health Services, Inc. (Kintegra at Arndt Middle)
• Gaston Family Health Services, Inc. (Kintegra at Northview Middle)
• Gaston Family Health Services, Inc. (Catawba Valley Family Medicine - Mountain View)
• Gaston Family Health Services, Inc. (Kintegra at Longview Elementary)
• Gaston Family Health Services, Inc. (Kintegra at Webb A. Murray Elementary)

• Federally Qualified Health Center (FQHC) in Hickory, NC
• Providers in Hickory, 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 Oct 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.