1. Home
  2. Directory
  3. North Carolina
  4. Statesville
  5. Clinic Center
  6. NPI Profile

KINTEGRA PEDIATRIC MEDICINE - STATESVILLE
NPI 1710237367
Clinic/Center - Federally Qualified Health Center (FQHC) in Statesville, NC

Active since September 11, 2012CLIA 34D0701976 · Waiver
518 BROOKDALE DR, STATESVILLE, NC 28677(704) 872-9595(704) 872-5851 Get Directions Write a Review

NPPES record last updated: May 7, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 7, 2021, Jan 15, 2020 (2 updates tracked since 2020).

About Kintegra Pediatric Medicine - Statesville NPPES

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

KINTEGRA PEDIATRIC MEDICINE - STATESVILLE (NPI 1710237367) is a healthcare organization registered as a federally qualified health center (fqhc) in Statesville, North Carolina and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through July 30, 2027 and lists Sharmila Anderson, Business Service Administrator, as its authorized official.

NPPES Registry Identity

NPI1710237367
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGASTON FAMILY HEALTH SERVICES, INC.
Location Address518 BROOKDALE DRStatesville, NC 28677-4108
Mailing Address200 E 2nd AveGastonia, NC 28052-4358 · (704) 874-1904 · Fax (704) 867-2134
Phone(704) 872-9595
Fax(704) 872-5851
Organization SubpartYesParent: Gaston Family Health Services, Inc
Authorized OfficialSharmila AndersonBusiness Service Administrator · (704) 874-1907
Enumeration DateSeptember 11, 2012
Last NPPES UpdateMay 7, 20212 updates tracked since enumeration
NPPES CertifiedMay 7, 2021
✔ NPI 1710237367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
518 BROOKDALE DR, Statesville, NC 28677
Open in Google Maps ↗

Other Names 1

Doing Business AsKintegra Pediatric Medicine - Statesville

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kintegra Pediatric Medicine - Statesville is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNorth CarolinaEnrollment IDO20040712000470Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

207

Medicare enrollment records show 207 clinicians reassign Medicare billing to Kintegra Pediatric Medicine - Statesville, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 15 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 16

Nurse Practitioner65
Clinical Social Worker52
Family Practice32
Mental Health Counselor27
Podiatry5
Chiropractic4
Internal Medicine4
Psychiatry4
8 other specialties14

Nearest to this location (20)

See all 207
Sharon Bryan, MSN, CPNP
Nurse Practitioner
NPI 1942452974
518 BROOKDALE DR
Statesville, NC 28677
(704) 874-3316
✔ PECOSSame address
Kathleen Harknett, MD
Pediatric Medicine
NPI 1346566833
518 BROOKDALE DR
Statesville, NC 28677
(704) 872-9595
✔ PECOSSame address
Alisia Dulaney, LCSW
Clinical Social Worker
NPI 1730470600
515 BROOKDALE DR
Statesville, NC 28677
(704) 380-3620
✔ PECOSSame address
Suja Raju, M.D.
Psychiatry
NPI 1003254806
515 BROOKDALE DR
Statesville, NC 28677
(704) 380-3620
✔ PECOSSame address
Mario Zapata, M.D.
Psychiatry
NPI 1992856033
515 BROOKDALE DR
Statesville, NC 28677
(704) 883-8660
✔ PECOSSame address
Karen Melendez, M.D.
Psychiatry
NPI 1184675977
1703 DAVIE AVE
Statesville, NC 28677
(704) 819-9191
✔ PECOS✔ Accepts Medicare0.6 mi
Brandi Anthony, LCSW
Clinical Social Worker
NPI 1154154466
1450 FERN CREEK DR
Statesville, NC 28625
(704) 818-9191
✔ PECOS✔ Accepts Medicare1.1 mi
Esenam Dankwa, PMHNP
Nurse Practitioner
NPI 1093428013
1450 FERN CREEK DR
Statesville, NC 28625
(704) 818-9191
✔ PECOS✔ Accepts Medicare1.1 mi
Alicia Hyde, LCSW
Clinical Social Worker
NPI 1841869757
1450 FERN CREEK DR
Statesville, NC 28625
(704) 818-9191
✔ PECOS1.1 mi
Benjamin Stacy, D.O.
Psychiatry
NPI 1093127367
1450 FERN CREEK DR
Statesville, NC 28625
(704) 818-9191
✔ PECOS✔ Accepts Medicare1.1 mi
Jocelyn Dobbins, DC
Chiropractic
NPI 1891640058
1022 SHELTON AVE
Statesville, NC 28677
(704) 838-1234
2.0 mi
Richard Nagle, DC
Chiropractic
NPI 1124231600
1022 SHELTON AVE
Statesville, NC 28677
(704) 838-1234
✔ Accepts Medicare2.0 mi
Virginia Wright, MD
Hospitalist
NPI 1023211489
1022 SHELTON AVE
Statesville, NC 28677
(704) 838-1234
✔ PECOS✔ Accepts Medicare2.0 mi
Emily Mears, FNP-BC
Nurse Practitioner
NPI 1225706344
1022 SHELTON AVE
Statesville, NC 28677
(704) 768-2080
✔ PECOS✔ Accepts Medicare2.0 mi
Ashley Rogers, RN
Nurse Practitioner
NPI 1497936009
1022 SHELTON AVE
Statesville, NC 28677
(704) 768-2080
✔ PECOS✔ Accepts Medicare2.0 mi
Jaymie Rowe, LMFT
Marriage and Family Therapist
NPI 1639594765
403 6TH AVE SW
Catawba, NC 28609
(828) 241-2734
✔ PECOS13 mi
Christian Sorensen, M.D.
Family Practice
NPI 1730138066
544 BRAWLEY SCHOOL RD
Mooresville, NC 28117
(704) 360-5190
✔ PECOS✔ Accepts Medicare15 mi
Amy Kilpatrick
Nurse Practitioner
NPI 1629934781
378 WILLIAMSON RD STE 204
Mooresville, NC 28117
(704) 978-8334
✔ PECOS✔ Accepts Medicare15 mi
Olinda Davidson, LCMHC
Mental Health Counselor
NPI 1023448156
2620 BALLS CREEK RD
Newton, NC 28658
(828) 464-4766
✔ PECOS18 mi
Brittany Fryer, LCSW
Clinical Social Worker
NPI 1528332053
172 S CLEMENT ST
Mocksville, NC 27028
(336) 477-2251
✔ PECOS19 mi
See all 207 clinicians

Source: 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 34D0701976

Kintegra Pediatric Medicine - Statesville · Statesville, NC
Active · expires Jul 30, 2027
CLIA Number34D0701976
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorKathleen Harknett
Laboratory Phone(704) 874-9595
Laboratory LocationKintegra Pediatric Medicine - Statesville518 Brookdale Drive, Statesville, NC 28677
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Gaston Family Health Services, Inc.'s NPI number?

The NPI number for Gaston Family Health Services, Inc. is 1710237367. It was assigned to this organization in the NPPES registry on September 11, 2012. The provider is doing business as Kintegra Pediatric Medicine - Statesville.

Where is Gaston Family Health Services, Inc. located?

Gaston Family Health Services, Inc. is located at 518 Brookdale Dr, Statesville, NC 28677. The listed phone number is (704) 872-9595.

What is Gaston Family Health Services, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Gaston Family Health Services, Inc. enrolled in Medicare?

Yes. Gaston Family Health Services, Inc. is registered in the Medicare PECOS enrollment system.

When is Gaston Family Health Services, Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Gaston Family Health Services, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 207 clinicians in 16 Medicare specialties reassign their Medicare billing to Gaston Family Health Services, Inc.. 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 Nurse Practitioner (65), Clinical Social Worker (52) and Family Practice (32). Of these, 5 practice at this address and 15 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Gaston Family Health Services, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0701976) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Gaston Family Health Services, Inc. accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and Ambetter of Tennessee list Gaston Family Health Services, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gaston Family Health Services, Inc. was last updated on May 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.