| Gateway Kidney Care Ii, Llc | |
|
1360 S 5th St Ste 268 Saint Charles MO 63301-2446 | |
| (720) 204-5760 | |
| Not Available |
| Full Name | Gateway Kidney Care Ii, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1360 S 5th St Ste 268, Saint Charles, Missouri |
| Authorized Official Name and Position | Aaron Molitor (CEO) |
| Authorized Official Contact | 9132321472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Kidney Care Ii, Llc 1600 Stout St Ste 2000 Denver CO 80202-3113 Ph: (720) 204-5760 | Gateway Kidney Care Ii, Llc 1360 S 5th St Ste 268 Saint Charles MO 63301-2446 Ph: (720) 204-5760 |
| NPI Number | 1720770407 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 1658726682 |
|---|---|
| Medicare Enrollment ID | O20231011003647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720770407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Karen E Brautigam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821197583 PECOS PAC ID: 3678662863 Enrollment ID: I20071211000693 |
| Provider Name | Laura Gers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992085583 PECOS PAC ID: 6002066453 Enrollment ID: I20121022000432 |
| Provider Name | Katelyn A Horowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649744145 PECOS PAC ID: 4284021700 Enrollment ID: I20220429002002 |
| Provider Name | Christine A Gallup |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083981831 PECOS PAC ID: 8224422597 Enrollment ID: I20220816000207 |
| Provider Name | Haley D Justus |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861896672 PECOS PAC ID: 9638565633 Enrollment ID: I20240731002392 |
| Provider Name | Darci F Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144990532 PECOS PAC ID: 7416346119 Enrollment ID: I20240918003617 |
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