Healthcare Provider Details

I. General information

NPI: 1972450336
Provider Name (Legal Business Name): GATEWAY TO CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 DUSTY ROSE DR
O FALLON MO
63368-6879
US

IV. Provider business mailing address

117 DUSTY ROSE DR
O FALLON MO
63368-6879
US

V. Phone/Fax

Practice location:
  • Phone: 636-747-4263
  • Fax: 636-294-6893
Mailing address:
  • Phone: 636-747-4263
  • Fax: 636-294-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DINAH WITHERSPOON
Title or Position: OWNER
Credential: DPT, PT, MHA
Phone: 314-496-9564