Individual provider Active NPI

Kevin A. Gall, DC

  • Chiropractor
  • Green Brook, NJ
National Provider Identifier
1043324205
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC03899 Issued in NJ
Practice address
309 Rock Ave
Green Brook, NJ 08812-2616
Phone
(732) 968-3900
Fax
(732) 968-3944
NPI assigned
Aug 17, 2006
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MC03899 NJ Primary

Addresses

Primary practice location

309 Rock Ave
Green Brook, NJ 08812-2616

Mailing address

20 Deer Path Cir
Green Brook, NJ 08812-2048
Phone (908) 510-8051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071227000020 NJ Practitioner - Chiropractic 0143310417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

309 Rock Ave
Green Brook, NJ 08812-2616
Phone (732) 968-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC03899NJMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gall & Casterline PC Chiropractor CurrentSince Jun 21, 1990 Accepting new patients

Locations

309 Rock Ave
Green Brook, NJ 08812
Phone (732) 968-3900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1043324205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DEER PATH CIR",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122048",
            "telephone_number": "908-510-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 ROCK AVE",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122616",
            "telephone_number": "732-968-3900",
            "fax_number": "732-968-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALL",
        "first_name": "KEVIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC03899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Brook, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.

Verify at the official NPI Registry.