NPIMap

Organization Active NPI

Gateway Internal Medicine and Pediatric Associates PLLC

  • Adolescent Medicine (Internal Medicine) Physician
  • Mt Sterling, KY
National Provider Identifier
1912066085
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
Legal business name
GATEWAY INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES PLLC
Doing business as
Gateway Internal Medicine and Pediatric Associates PLLC
Practice address
103 Commonwealth Drive
Mt Sterling, KY 40353-9317
Phone
(859) 498-7716
Fax
(859) 497-0044
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Mrs. Donna Lynn Raper
Title
Practice Manager
Phone
(859) 498-7715

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0000X Primary
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

103 Commonwealth Drive
Mt Sterling, KY 40353-9317

Mailing address

PO Box 689
Mt Sterling, KY 40353-0689
Phone (859) 498-7716

Other identifiers 1

IdentifierTypeStateIssuer
65934036MedicaidKY

Other names 1

  • Gateway Internal Medicine and Pediatric Associates PLLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1912066085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403530689",
            "telephone_number": "859-498-7716",
            "fax_number": "859-497-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COMMONWEALTH DRIVE",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403539317",
            "telephone_number": "859-498-7716",
            "fax_number": "859-497-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "RAPER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "859-498-7715",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65934036",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Internal Medicine and Pediatric Associates PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Sterling, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.