Isabella Andrea Vallenilla Gallardo, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

89654 Issued in SC

Practice address

124 Professional Park Dr Ste a
Conway, SC 29526-9260

Phone

(843) 347-7111

NPI assigned

Jun 3, 2020

Last updated

Mar 12, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Conway Hospital, Inc.

  dba Conway Medical Center

  • General Acute Care Hospital
  • Conway, SC
  • NPI 1134172000
  Medicare reassignment NPD
• Conway Hospital, Inc.

  dba CMC Vascular

  • Vascular Surgery Physician
  • Conway, SC
  • NPI 1134910763
  NPD
• Conway Hospital, Inc.

  dba CMC Primary Care Little River

  • Internal Medicine Physician
  • Little River, SC
  • NPI 1558025783
  NPD (past)

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1235753468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PATIENT ACCOUNTING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PROFESSIONAL PARK DR STE A",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "843-347-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2367B Cypress Cir",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268921",
            "country_code": "US",
            "telephone_number": "843-349-1001",
            "fax_number": "843-349-1008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLENILLA GALLARDO",
        "first_name": "ISABELLA",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "89654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896542",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Urgent Care & Family Medicine Conway, LLC
• Zofia Julia Uszok
• Saujanya Vadoothker, M.D.
• Ami S Vaidya, MD
• Darryl K Valentine, PA
• Simone Isabel Van Der Lee
• Lauren Van Wie, MS BCBA
• Marigrace Vandeventer
• Ut Uyen N Vanhoogen
• Ruben Vasquez Jr., MD

• Pediatrics Physician in Conway, SC
• Providers in Conway, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.