Individual provider Active NPI

Megan Elizabeth Luellen, PHARM D

  • Pharmacist
  • Gallup, NM
National Provider Identifier
1295363273
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18435 Issued in NM
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1185
NPI assigned
Mar 27, 2020
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18435 NM Primary

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

3607 Chaco Dr
Gallup, NM 87301-4556
Phone (918) 605-6044

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
18435NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1295363273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 CHACO DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014556",
            "telephone_number": "918-605-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUELLEN",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "18435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.