Active NPI
Nolan A Gall, MD
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- St Augustine, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- License
- ME161787
- Practice address
- 45 Groover Loop Ste 201
St Augustine, FL 32086-6586 - Phone
- (904) 634-0640
- Fax
- (904) 634-0203
- NPI assigned
- Mar 27, 2018
- Last updated
- Jul 28, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | ME161787 | FL | Primary |
| Pain Medicine Physician | 208VP0000X | ME1616787 | FL |
Addresses
Primary practice location
45 Groover Loop Ste 201
St Augustine, FL 32086-6586
Mailing address
6800 Southpoint Pkwy Ste 300
Jacksonville, FL 32216-8203
Phone (904) 634-0604
Other practice location 1
2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 634-0640
Other practice location 2
1690 US Highway 1 S Ste F
St Augustine, FL 32084-6024
Phone (904) 634-0640
Other practice location 3
216 Southpark Cir E Ste 216
St Augustine, FL 32086-5135
Phone (904) 634-0640
Other practice location 4
3055 County Road 210 W Ste 110
St Johns, FL 32259-7001
Phone (904) 634-0640
Other practice location 5
4565 US Highway 17 Ste 200
Fleming Island, FL 32003-4823
Phone (904) 634-0640
Other practice location 6
15255 Max Legget Pkwy Ste 5300
Jacksonville, FL 32218-7274
Phone (904) 634-0640
Other practice location 7
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082-6600
Phone (904) 634-0640
Other practice location 8
10475 Centurion Pkwy N Ste 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640
Other practice location 9
2627 Riverside Ave Ste 300
Jacksonville, FL 32204-4717
Phone (904) 634-0640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119560200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Georgetown University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10475 Centurion Pkwy N
Suite 220
Jacksonville, FL 32256-5004
Phone (904) 634-0640
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.26 of 100
- Quality
- 84.11
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME1616787 | FL | MD | Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Orthopedic Specialists, LLC | Current | Accepting new patients | |
| Southeast Orthopedic Specialists, LLC | Pain Medicine | Current | Accepting new patients |
| Center for Orthopedic Research and Education, LLC | Pain Medicine | Past | Accepting new patients |
Locations
4565 US Highway 17
Ste 200
Fleming Island, FL 32003
Phone (904) 630-0640
10475 Centurion Pkwy N
Ste 220
Jacksonville, FL 32256
Phone 9046340640 ext. 1014
15255 Max Leggett Pkwy
Ste 5300
Jacksonville, FL 32218
Phone (904) 203-1386
2 Shircliff Way
Ste 605
Jacksonville, FL 32204
Phone (904) 328-5979
2627 Riverside Ave
Fl 3
Jacksonville, FL 32204
Phone 9046340640 ext. 1014
2627 Riverside Ave
Ste 300
Jacksonville, FL 32204
Phone 9046340640 ext. 1014
6800 Southpoint Pkwy
Ste 300
Jacksonville, FL 32216
232 Ponte Vedra Park Dr
Ponte Vedra Beach, FL 32082
Phone (904) 285-7546
216 Southpark Cir E
Ste 216
St Augustine, FL 32086
Phone (904) 634-0203
45 Groover Loop
Unit 201
St Augustine, FL 32086
Phone (904) 634-0604
1690 US Highway 1 S
Ste F
St Augustine Beach, FL 32084
Phone (904) 634-0460
3055 County Road 210 W
Ste 110
St Johns, FL 32259
Phone (904) 634-0203
Interoperability endpoints
- nolan.gall.1@22724.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1629025820
Pain Medicine
-
- Durable Medical Equipment & Medical Supplies
- Saint Johns, FL
- NPI 1538952379
-
dba The CORE Institute
- Orthopaedic Surgery Physician
- Phoenix, AZ
- NPI 1427095801
Pain Medicine
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- General Acute Care Hospital
- St Augustine, FL
- NPI 1144211020
-
dba Brooks Rehabilitation Hospital Bartram Campus
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1376114413
Inpatient rehabilitation facility
-
dba Brooks Rehabilitation
- Rehabilitation Hospital
- Jacksonville, FL
- NPI 1912947748
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753660800000",
"number": "1245735893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 SOUTHPOINT PKWY STE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168203",
"telephone_number": "904-634-0604",
"fax_number": "904-634-0203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 GROOVER LOOP STE 201",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320866586",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203"
}
],
"practiceLocations": [
{
"address_1": "2 Shircliff Way Ste 605",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322044762",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1690 US Highway 1 S Ste F",
"address_purpose": "LOCATION",
"city": "St Augustine",
"state": "FL",
"postal_code": "320846024",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "216 Southpark Cir E Ste 216",
"address_purpose": "LOCATION",
"city": "St Augustine",
"state": "FL",
"postal_code": "320865135",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3055 County Road 210 W Ste 110",
"address_purpose": "LOCATION",
"city": "St Johns",
"state": "FL",
"postal_code": "322597001",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4565 US Highway 17 Ste 200",
"address_purpose": "LOCATION",
"city": "Fleming Island",
"state": "FL",
"postal_code": "320034823",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15255 Max Legget Pkwy Ste 5300",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322187274",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "232 Ponte Vedra Park Dr",
"address_purpose": "LOCATION",
"city": "Ponte Vedra Beach",
"state": "FL",
"postal_code": "320826600",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10475 Centurion Pkwy N Ste 220",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322565004",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2627 Riverside Ave Ste 300",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322044717",
"country_code": "US",
"telephone_number": "904-634-0640",
"fax_number": "904-634-0203",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALL",
"first_name": "NOLAN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-27",
"last_updated": "2025-07-28",
"certification_date": "2025-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "FL",
"license": "ME161787",
"primary": true
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "FL",
"license": "ME1616787",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119560200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.