Individual provider Active NPI

Leslie Gallagher, NP

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1063435683
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
600013 Issued in NC
Practice address
311-4E Judges Road
Wilmington, NC 28405-3655
Phone
(415) 899-9800
Fax
(415) 899-9805
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11529 CA
Psychiatry Physician 2084P0800X 600013 NC
Nurse Practitioner 363L00000X 600013 NC Primary

Addresses

Primary practice location

311-4E Judges Road
Wilmington, NC 28405-3655

Mailing address

P.O. Box 696
Hampstead, NC 28443-0696
Phone (910) 791-6767

Other identifiers 2

IdentifierTypeStateIssuer
7000774MedicaidNC
NP0115290MedicaidCA

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11529CAMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Act Medical Group PA Past Accepting new patients
Gerihealthsolutions, Inc. Gerontology Past Accepting new patients
Act Medical Group, PA Past Accepting new patients
Priest NP Services Gerontology Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1063435683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 696",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284430696",
            "telephone_number": "910-791-6767",
            "fax_number": "910-791-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311-4E JUDGES ROAD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053655",
            "telephone_number": "415-899-9800",
            "fax_number": "415-899-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "LESLIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "11529",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "600013",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "600013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000774",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0115290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.