NPIMap

Individual provider Active NPI

Kevin L Galloway V, DO

  • Obstetrics & Gynecology Physician
  • Jackson, MS
National Provider Identifier
1073507547
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
16585 Issued in MS
Practice address
1860 Chadwick Dr
Suite 300
Jackson, MS 39204-3463
Phone
(601) 376-2999
Fax
(601) 376-2989
NPI assigned
Sep 9, 2005
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 16585 MS Primary

Addresses

Primary practice location

1860 Chadwick Dr
Suite 300
Jackson, MS 39204-3463

Mailing address

PO Box 6004
Urbana, IL 61803-6004
Phone (217) 383-6792

Other identifiers 1

IdentifierTypeStateIssuer
00123174MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622001193 MS Practitioner - Obstetrics/Gynecology 3173568912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Chicago College of Osteopathy, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

130 Highland Pkwy
Picayune, MS 39466-5574
Phone (601) 358-9400

146 Highland Pkwy
Picayune, MS 39466-5575
Phone (601) 358-9765

1702 Hwy 11 N
Suite a Highland Family Medicine Clinic
Picayune, MS 39466-2016
Phone (601) 799-3130

906 6TH Ave
Picayune, MS 39466-3802
Phone (601) 798-7529

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital Obstetrics & Gynecology CurrentSince Mar 12, 2021 Accepting new patients
Highland Community Hospital Physicians Obstetrics & Gynecology CurrentSince Mar 12, 2021 Accepting new patients
Forrest County General Hospital Current Accepting new patients
Forrest County General Hospital CurrentSince Mar 12, 2021 Accepting new patients
Forrest County General Hospital Past Accepting new patients
Carle Health Medical Group Past Accepting new patients
Forrest County General Hospital Past Accepting new patients
River Oaks Management Company LLC Obstetrics & Gynecology Past Accepting new patients

Locations

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

128 Highland Pkwy
Ste 202
Picayune, MS 39466
Phone (601) 358-9422

146 Highland Pkwy
Ste C
Picayune, MS 39466
Phone (601) 358-9765

Organizations & group practices 9

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 2

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1073507547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6004",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036004",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DR",
            "address_2": "SUITE 300",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043463",
            "telephone_number": "601-376-2999",
            "fax_number": "601-376-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "V",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "16585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123174",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.