Merrissa Danyol Gallegos, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

244062 Issued in GA

Practice address

2850 Hog Mountain Rd
#102
Dacula, GA 30019-5934

Phone

(770) 614-5454

NPI assigned

Oct 11, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Emory University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661
  Medicare reassignment Care Compare group NPD
• Gwinnett Medical Group, Inc

  • General Practice Physician
  • Lawrenceville, GA
  • NPI 1780747469
  NPD (past)

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1235689498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 HOG MOUNTAIN RD",
            "address_2": "#102",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 HOG MOUNTAIN RD",
            "address_2": "#102",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195934",
            "telephone_number": "770-614-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MERRISSA",
        "middle_name": "DANYOL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "244062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "merrissa.gallegosnp.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "2850 Hog Mountain Rd",
            "address_2": "#102",
            "city": "Dacula",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300195934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amaris Primrose Galloway
• Sidney Eugene Galloway, DMD
• Jasmine Garner
• Brittny Garrison
• Darnell L Gaskins

• Family Nurse Practitioner in Dacula, GA
• Providers in Dacula, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.