GATEWAY WELLNESS CLINIC
NPI 1881567568
Clinic/Center - Primary Care in Vicksburg, MS
About Gateway Wellness Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GATEWAY WELLNESS CLINIC (NPI 1881567568) is a healthcare organization registered as a primary care in Vicksburg, Mississippi and active in the NPI registry since September 2025. The organization lists Kimberly Carson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Gateway Wellness Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Wellness Clinic's NPI number?
The NPI number for Gateway Wellness Clinic is 1881567568. It was assigned to this organization in the NPPES registry on September 29, 2025.
Where is Gateway Wellness Clinic located?
Gateway Wellness Clinic is located at 1016 Mission 66, Vicksburg, MS 39183. The listed phone number is (601) 218-0969.
What is Gateway Wellness Clinic's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Gateway Wellness Clinic enrolled in Medicare?
Yes. Gateway Wellness Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Gateway Wellness Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Gateway Wellness Clinic. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Gateway Wellness Clinic was last updated on September 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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 Wellness Clinic · NPI 1881567568
Primary Care organization in Vicksburg, Mississippi. Organization record, active in the CMS NPPES registry since September 29, 2025.
## Identity
- **NPI:** 1881567568 (Entity type: Organization)
- **Enumerated:** September 29, 2025
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Kimberly Carson, OWNER
## Practice location
- **Address:** 1016 MISSION 66, Vicksburg, MS 39183-2752
- **Phone:** (601) 218-0969
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1881567568) · Data from the CMS NPPES public registry.