Active NPI
Jessica Lynn Gallus, RN
- Emergency Registered Nurse
- Harlem, MT
National Provider Identifier
1225283328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 34824
- Practice address
- 456 Gros Ventre Ave
Harlem, MT 59526 - Phone
- (406) 353-3100
- NPI assigned
- Nov 18, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 34824 | MT | Primary |
Addresses
Primary practice location
456 Gros Ventre Ave
Harlem, MT 59526
Mailing address
RR 1 Box 67
Harlem, MT 59526-9705
Phone (406) 353-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34824 | Other | MT | LICENSE |
Other names 1
- Jessica Lynn Roth
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34824 | MT | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248393600000",
"number": "1225283328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 67",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269705",
"telephone_number": "406-353-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 GROS VENTRE AVE",
"city": "HARLEM",
"state": "MT",
"postal_code": "59526",
"telephone_number": "406-353-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLUS",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-18",
"last_updated": "2009-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "MT",
"license": "34824",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "34824",
"state": "MT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "ROTH",
"middle_name": "LYNN",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Harlem, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.