Active NPI
Michael Gallamore
- Physical Therapist
- Van Buren, AR
National Provider Identifier
1164215885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5623
- Practice address
- 619 Fayetteville Rd
Van Buren, AR 72956-3418 - Phone
- (479) 474-0041
- Fax
- (479) 474-0099
- NPI assigned
- May 26, 2025
- Last updated
- May 26, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5623 | AR | Primary |
Addresses
Primary practice location
619 Fayetteville Rd
Van Buren, AR 72956-3418
Mailing address
6500 Galven Way
Fort Smith, AR 72916-8978
Phone (479) 474-0041
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5623 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748217600000",
"number": "1164215885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 GALVEN WAY",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729168978",
"telephone_number": "479-474-0041",
"fax_number": "479-474-0099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 FAYETTEVILLE RD",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729563418",
"telephone_number": "479-474-0041",
"fax_number": "479-474-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAMORE",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-26",
"last_updated": "2025-05-26",
"certification_date": "2025-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "AR",
"license": "5623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Buren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.