Individual provider Active NPI

Elizabeth Ashley Gallaway, APRN

  • Nurse Practitioner
  • Stillwater, OK
National Provider Identifier
1033814785
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
212142 Issued in OK
Practice address
1323 W 6TH Ave
Stillwater, OK 74074-4399
Phone
(405) 372-1480
NPI assigned
Apr 3, 2023
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 212142 OK
Nurse Practitioner 363L00000X R0113948 OK
Nurse Practitioner 363L00000X 212142 OK Primary

Addresses

Primary practice location

1323 W 6TH Ave
Stillwater, OK 74074-4399

Mailing address

403 E Noble Rd
Stillwater, OK 74075-1952
Phone (405) 614-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726003507 OK Practitioner - Nurse Practitioner 9830550672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Emergency Services, PCGroup PAC ID 8224212949, 57 clinicians

Practice addresses (Care Compare)

1323 NW 6TH Ave
Stillwater, OK 74074-4306
Phone (405) 372-1480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0113948OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Oklahoma PC Nurse Practitioner CurrentSince Dec 27, 2024 Accepting new patients
South Central Emergency Services PC Nurse Practitioner CurrentSince Aug 1, 2023 Accepting new patients
Aky MD, LLC Past Accepting new patients

Locations

4801 SE 15th St
Del City, OK 73115
Phone (405) 500-3380

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

9417 N Council Rd
Oklahoma City, OK 73162
Phone (405) 500-3280

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.973232

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1033814785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E NOBLE RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740751952",
            "telephone_number": "405-614-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744399",
            "telephone_number": "405-372-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAWAY",
        "first_name": "ELIZABETH",
        "middle_name": "ASHLEY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "212142",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0113948",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "212142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.