Individual provider Active NPI

Kristalyn K Gallagher, D.O.

  • Surgical Oncology Physician
  • Chapel Hill, NC
National Provider Identifier
1114156130
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
2014-02039 Issued in NC
Practice address
170 Manning Dr
CB#7213
Chapel Hill, NC 27599-7213
Phone
(919) 966-4416
Fax
(919) 966-8806
NPI assigned
Jul 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4760 OK
Surgery Physician 208600000X E-8087 AR
Surgical Oncology Physician 2086X0206X 2014-02039 NC Primary

Addresses

Primary practice location

170 Manning Dr
CB#7213
Chapel Hill, NC 27599-7213

Mailing address

170 Manning Dr
CB#7213
Chapel Hill, NC 27599-7213
Phone (919) 966-4416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150105002131 NC Practitioner - Surgical Oncology 2466581657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220

102 Mason Farm Rd
Chapel Hill, NC 27514-4617

430 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

460 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy40
Melanoma (skin cancer) excision26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-02039NCMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill Current Accepting new patients
University of North Carolina at Chapel Hill Surgery CurrentSince Oct 7, 2014 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

102 Mason Farm Rd
Chapel Hill, NC 27514
Phone (919) 966-1459

102 Mason Farm Rd
Chapel Hill, NC 27599
Phone (919) 966-1459

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Interoperability endpoints

  • Direct secure messaging: kgallagher101721@direct.unc.nchie.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1114156130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MANNING DR",
            "address_2": "CB#7213",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997213",
            "telephone_number": "919-966-4416",
            "fax_number": "919-966-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MANNING DR",
            "address_2": "CB#7213",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997213",
            "telephone_number": "919-966-4416",
            "fax_number": "919-966-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KRISTALYN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "4760",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-8087",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NC",
            "license": "2014-02039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.