GATEWAY MEDICAL CLINIC
NPI 1629026133
Family Medicine in Crestview, FL
About Gateway Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GATEWAY MEDICAL CLINIC (NPI 1629026133) is a healthcare organization registered as a family medicine in Crestview, Florida and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 11, 2027 and lists Jennifer L Jackson, Sr Dir Onboarding & Prov Enrollment, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gateway Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to Gateway Medical Clinic, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 22Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 10D0898737
Gateway Medical Clinic · Crestview, FLFrequently 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 Crestview Hospital Corporation's NPI number?
The NPI number for Crestview Hospital Corporation is 1629026133. It was assigned to this organization in the NPPES registry on May 5, 2006. The provider is doing business as Gateway Medical Clinic.
Where is Crestview Hospital Corporation located?
Crestview Hospital Corporation is located at 127C E. Redstone Ave, Crestview, FL 32539. The listed phone number is (850) 423-0061.
What is Crestview Hospital Corporation's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Crestview Hospital Corporation enrolled in Medicare?
Yes. Crestview Hospital Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Crestview Hospital Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 9 Medicare specialties reassign their Medicare billing to Crestview Hospital Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (5), Nurse Practitioner (5) and Family Practice (3). Of these, 4 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Crestview Hospital Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0898737) is associated with this NPI, valid through March 11, 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 Crestview Hospital Corporation was last updated on March 18, 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.
# Gateway Medical Clinic · NPI 1629026133
Family Medicine organization in Crestview, Florida. Organization record, active in the CMS NPPES registry since May 5, 2006.
## Identity
- **NPI:** 1629026133 (Entity type: Organization)
- **Enumerated:** May 5, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Crestview Hospital Corporation
- **Organization subpart:** No
- **Authorized official:** Jennifer Jackson, SR DIR ONBOARDING & PROV ENROLLMENT
## Practice location
- **Address:** 127C E. REDSTONE AVE, Crestview, FL 32539-5356
- **Phone:** (850) 423-0061
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 22 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (5), Nurse Practitioner (5), Family Practice (3); 4 practice at this address and 10 within 10 miles; [full list](https://npiprofile.com/npi/1629026133/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 18, 2022
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1629026133) · Data from the CMS NPPES public registry.