Active NPI
Diana Gallegos, AT, ATC
- Athletic Trainer
- Tempe, AZ
National Provider Identifier
1265895015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT4868
- Practice address
- 1251 E Southern Ave
Tempe, AZ 85282-5605 - Phone
- (480) 839-3402
- NPI assigned
- Mar 30, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT4868 | TX | Primary |
| Athletic Trainer | 2255A2300X | 1320 | AZ |
Addresses
Primary practice location
1251 E Southern Ave
Tempe, AZ 85282-5605
Mailing address
445 S Dobson Rd
Apt 3090
Mesa, AZ 85202-1825
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1320 | AZ | MD | Psychologist |
| AT4868 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1265895015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 S DOBSON RD",
"address_2": "APT 3090",
"city": "MESA",
"state": "AZ",
"postal_code": "852021825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 E SOUTHERN AVE",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852825605",
"telephone_number": "480-839-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLEGOS",
"first_name": "DIANA",
"credential": "AT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-30",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT4868",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1320",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.