Individual provider Active NPI

Caroline Victoria Gallin, OT

  • Gerontology Occupational Therapist
  • Columbia, SC
National Provider Identifier
1326509480
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
5511 Issued in SC
Practice address
4520 Trenholm Rd
Columbia, SC 29206-4425
Phone
(803) 787-1234
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 5511 SC Primary

Addresses

Primary practice location

4520 Trenholm Rd
Columbia, SC 29206-4425

Mailing address

5 Brushwood CT
Columbia, SC 29229-9254
Phone (845) 323-0462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190625003146 SC Practitioner - Occupational Therapist in Private Practice 9133453137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5511SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc CurrentSince Apr 29, 2019 Accepting new patients

Locations

3736 Robert M Grissom Pkwy
Myrtle Beach, SC 29577
Phone (843) 448-9300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1326509480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRUSHWOOD CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299254",
            "telephone_number": "845-323-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 TRENHOLM RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064425",
            "telephone_number": "803-787-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIN",
        "first_name": "CAROLINE",
        "middle_name": "VICTORIA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "SC",
            "license": "5511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.