Individual provider Active NPI

Tara Lily Gallant

  • Student in an Organized Health Care Education/Training Program
  • Elk Grove, CA
National Provider Identifier
1033814884
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
9700 W Taron Dr
Elk Grove, CA 95757-8145
Phone
(916) 686-7300
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

9700 W Taron Dr
Elk Grove, CA 95757-8145

Mailing address

9700 W Taron Dr
Elk Grove, CA 95757-8145
Phone (916) 686-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722002907 NH Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 2860938263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1680480000000",
    "number": "1033814884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 W TARON DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578145",
            "telephone_number": "916-686-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 W TARON DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957578145",
            "telephone_number": "916-686-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "TARA",
        "middle_name": "LILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.