Jessica D Gallagher, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35077307 Issued in OH

Practice address

302 W Main St
Fairborn, OH 45324-5037

Phone

(937) 281-4673

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

Ohio State University College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Decoach Team LLCGroup PAC ID 7517244551, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drgallagher@yspci-oh.direct.office.nextgen.com

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.

• Decoach Team LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  Medicare reassignment Care Compare group
• Decoach Team LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD
• Family Physicians of Huber Heights

  • Family Medicine Physician
  • Huber Heights, OH
  • NPI 1720289432
  NPD (past)
• Greene Memorial Hospital Services Inc

  • Family Medicine Physician
  • Miamisburg, OH
  • NPI 1457384380
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1124197793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245037",
            "telephone_number": "937-281-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 N Detroit St",
            "address_purpose": "LOCATION",
            "city": "Xenia",
            "state": "OH",
            "postal_code": "453852909",
            "country_code": "US",
            "telephone_number": "937-610-4673",
            "fax_number": "937-736-2615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Dayton St Unit 106",
            "address_purpose": "LOCATION",
            "city": "Yellow Springs",
            "state": "OH",
            "postal_code": "453871778",
            "country_code": "US",
            "telephone_number": "937-767-1088",
            "fax_number": "937-767-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JESSICA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35077307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2247401",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00432941",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000387041",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kymbra Fyffe
• Scott James Gachet, PA
• Danielle Gainer, M.D.
• Nakesha Gainey
• James E Gallagher, PA-C
• Kristina S Gambill, LMT
• Innocent Rubibi Ganza
• Olga Garcia
• Katie Lynn Gardner, CPHT
• Allison Renee Garrison

• Family Medicine Physician in Fairborn, OH
• Providers in Fairborn, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.