Active NPI
Bonnie Lynn Galloway, CNM
- Midwife
- Lewisburg, PA
National Provider Identifier
1336120096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- MW010239
- Practice address
- 3 Hospital Dr
Suite 312
Lewisburg, PA 17837-9362 - Phone
- (570) 523-8700
- Fax
- (570) 523-8705
- NPI assigned
- Nov 9, 2005
- Last updated
- Jul 9, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 72000123A | IN | |
| Midwife | 176B00000X | MW010239 | PA | Primary |
Addresses
Primary practice location
3 Hospital Dr
Suite 312
Lewisburg, PA 17837-9362
Mailing address
3 Hospital Dr
Suite 312
Lewisburg, PA 17837-9362
Phone (570) 523-8700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4088840-10 | Medicaid | MI | |
| 200857240 | Medicaid | IN | |
| 000000577790 | Other | IN | BCBS |
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72000123A | IN | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1336120096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 HOSPITAL DR",
"address_2": "SUITE 312",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178379362",
"telephone_number": "570-523-8700",
"fax_number": "570-523-8705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 HOSPITAL DR",
"address_2": "SUITE 312",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178379362",
"telephone_number": "570-523-8700",
"fax_number": "570-523-8705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLOWAY",
"first_name": "BONNIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "IN",
"license": "72000123A",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "PA",
"license": "MW010239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4088840-10",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200857240",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000577790",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lewisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.