# GATEWAY INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Gateway Internal Medicine and Pediatric Associates PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912066085
- **Authorized official:** MRS. DONNA LYNN RAPER (PRACTICE MANAGER)
- **Authorized official phone:** (859) 498-7715

## Contact information

- **Practice address:** 103 COMMONWEALTH DRIVE, MT STERLING, KY 40353-9317
- **Practice address phone:** (859) 498-7716
- **Practice address fax:** (859) 497-0044
- **Mailing address:** PO BOX 689, MT STERLING, KY 40353-0689
- **Mailing address phone:** (859) 498-7716
- **Mailing address fax:** (859) 497-0044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | — | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 05/25/2012