Individual provider Active NPI

Elizabeth Galloway, PA-C

  • Physician Assistant
  • Goodyear, AZ
National Provider Identifier
1194921841
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3637 Issued in AZ
Practice address
13555 W McDowell Rd
Suite 104
Goodyear, AZ 85395-2624
Phone
(623) 932-9636
Fax
(623) 932-9643
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3637 AZ Primary

Addresses

Primary practice location

13555 W McDowell Rd
Suite 104
Goodyear, AZ 85395-2624

Mailing address

3601 E McDowell Rd
Apt 1020
Phoenix, AZ 85008-4366
Phone (602) 291-3339

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3637AZMDClinical Psychologist

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/11c92883-3ba8-4054-8136-467108df0876/

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226880000000",
    "number": "1194921841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 E MCDOWELL RD",
            "address_2": "APT 1020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084366",
            "telephone_number": "602-291-3339",
            "fax_number": "623-932-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "SUITE 104",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952624",
            "telephone_number": "623-932-9636",
            "fax_number": "623-932-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2008-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.