# GATEWAY DIRECT PRIMARY CARE JV LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marathon Health- Chesterfield MO-Woodlake Dr
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154970127
- **Authorized official:** JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
- **Authorized official phone:** (704) 936-5546

## Contact information

- **Practice address:** 1574 WOODLAKE DR, CHESTERFIELD, MO 63017-5712
- **Practice address phone:** (866) 808-6005
- **Mailing address:** 1400 WEWATTA ST STE 350, DENVER, CO 80202-5553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/11/2019
- **Last updated:** 09/28/2026