Individual provider Active NPI

Garrett Keith Gallentine, D.C

  • Chiropractor
  • Cincinnati, OH
National Provider Identifier
1124462866
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4374 Issued in OH
Practice address
11123 Montgomery Rd
Suite 100
Cincinnati, OH 45249-2389
Phone
(513) 239-8375
NPI assigned
Apr 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4374 OH Primary

Addresses

Primary practice location

11123 Montgomery Rd
Suite 100
Cincinnati, OH 45249-2389

Mailing address

11123 Montgomery Rd
Suite 100
Cincinnati, OH 45249-2389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000240 OH Practitioner - Chiropractic 3072755735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4374OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Docs Corporation Chiropractor Current Accepting new patients
Wellness Docs CurrentSince Jul 31, 2020 Accepting new patients

Locations

11123 Montgomery Rd
Ste 105
Cincinnati, OH 45249
Phone (513) 342-1700

Organizations & group practices 2

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1124462866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11123 MONTGOMERY RD",
            "address_2": "SUITE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11123 MONTGOMERY RD",
            "address_2": "SUITE 100",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452492389",
            "telephone_number": "513-239-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLENTINE",
        "first_name": "GARRETT",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.