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GATEWAY DIRECT PRIMARY CARE
NPI 1548893530
Family Medicine in Creve Coeur, MO

Active since February 18, 2020CLIA 26D2176638 · Waiver
11770 OLIVE BLVD, CREVE COEUR, MO 63141(866) 808-6005 Get Directions Write a Review

NPPES record last updated: July 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 28, 2022, Dec 7, 2021, Jan 28, 2021 and 1 more (4 updates tracked since 2020).

About Gateway Direct Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GATEWAY DIRECT PRIMARY CARE (NPI 1548893530) is a healthcare organization registered as a family medicine in Creve Coeur, Missouri and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through December 18, 2027 and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1548893530
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGATEWAY DIRECT PRIMARY CARE JV LLC
Location Address11770 OLIVE BLVDCreve Coeur, MO 63141-7053
Mailing Address1400 Wewatta St Ste 350Denver, CO 80202-5553
Phone(866) 808-6005
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateFebruary 18, 2020
Last NPPES UpdateJuly 28, 20224 updates tracked since enumeration
NPPES CertifiedJuly 28, 2022
✔ NPI 1548893530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
11770 OLIVE BLVD, Creve Coeur, MO 63141
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Other Names 1

Doing Business AsGateway Direct Primary Care

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2176638

Gateway Direct Primary Care Jv LLC · Creve Coeur, MO
Active · expires Dec 18, 2027
CLIA Number26D2176638
Laboratory TypePhysician Office
Certificate Effective DateDecember 19, 2025
Certificate Expiration DateDecember 18, 2027
Laboratory DirectorKelly Demeyere
Laboratory Phone(303) 877-2468
Laboratory LocationGateway Direct Primary Care Jv LLC11770 Olive Blvd, Creve Coeur, MO 63141
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RSS WILLIAM SCHLUTER DDS LLC
Dentist
11770 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 824-0701
KELSEY R BARBERO PA-C
Family Medicine
11770 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (866) 808-6005
ANDREA LUI M.D.
Family Medicine
11770 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (314) 380-3014
EVERSIDE HEALTH LLC
Family Medicine
11770 OLIVE BLVD
CREVE COEUR, MO 63141
St. Louis County (866) 808-6005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gateway Direct Primary Care Jv LLC's NPI number?

The NPI number for Gateway Direct Primary Care Jv LLC is 1548893530. It was assigned to this organization in the NPPES registry on February 18, 2020. The provider is doing business as Gateway Direct Primary Care.

Where is Gateway Direct Primary Care Jv LLC located?

Gateway Direct Primary Care Jv LLC is located at 11770 Olive Blvd, Creve Coeur, MO 63141. The listed phone number is (866) 808-6005.

What is Gateway Direct Primary Care Jv LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Gateway Direct Primary Care Jv LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2176638) is associated with this NPI, valid through December 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gateway Direct Primary Care Jv LLC was last updated on July 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.