Individual provider Active NPI

Joseph Blane Gallagher

  • Speech/Language/Hearing Specialist/Technologist
  • Orange City, FL
National Provider Identifier
1053989582
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X
License
AS5409 Issued in FL
Practice address
742 N Volusia Ave
Orange City, FL 32763-4857
Phone
(386) 561-9496
NPI assigned
Jun 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/Technologist 235500000X AS5409 FL Primary

Addresses

Primary practice location

742 N Volusia Ave
Orange City, FL 32763-4857

Mailing address

742 N Volusia Ave
Orange City, FL 32763-4857
Phone (386) 561-9496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AS5409FLMDSpeech/Language/Hearing Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1053989582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 N VOLUSIA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327634857",
            "telephone_number": "386-561-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 N VOLUSIA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327634857",
            "telephone_number": "386-561-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JOSEPH",
        "middle_name": "BLANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "FL",
            "license": "AS5409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.