Active NPI
Delores A Gallo, CRNA
- Certified Registered Nurse Anesthetist
- Springfield, IL
National Provider Identifier
1013984889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209000851
- Practice address
- 1025 S 6TH St
Springfield, IL 62703-2403 - Phone
- (217) 528-7541
- NPI assigned
- Mar 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209000851 | IL | Primary |
Addresses
Primary practice location
1025 S 6TH St
Springfield, IL 62703-2403
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041207588 | Other | IL | RN LICENSE |
| 045954 | Other | CCNA CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic, LLP | Current | Accepting new patients |
Locations
300 N Broad St
Carlinville, IL 62626
Phone (217) 544-2020
7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827
1025 S 6th St
Springfield, IL 62703
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
Interoperability endpoints
- delores.gallo.1@28977.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1780638478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1013984889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S 6TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627032403",
"telephone_number": "217-528-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 S 6TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627032403",
"telephone_number": "217-528-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLO",
"first_name": "DELORES",
"middle_name": "A",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-01",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209000851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "041207588",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCNA CERTIFICATION",
"identifier": "045954",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.