Daniel Bradford Gallo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11976 Issued in GA

Practice address

2061 Experiment Station Rd Ste 505
Watkinsville, GA 30677-5327

Phone

(706) 310-0324

NPI assigned

Jul 20, 2023

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care of Oconee, LLCGroup PAC ID 5991090540, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Urgent Care of Oconee, LLC

  • Multi-Specialty Clinic/Center
  • Watkinsville, GA
  • NPI 1760839500
  Medicare reassignment Care Compare group NPD
• Urgent Care of Oconee, LLC

  • Urgent Care Clinic/Center
  • Athens, GA
  • NPI 1093468951
  NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1407536709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 EXPERIMENT STATION RD STE 505",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775327",
            "telephone_number": "706-310-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 EXPERIMENT STATION RD STE 505",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775327",
            "telephone_number": "706-310-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "DANIEL",
        "middle_name": "BRADFORD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-20",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Bell Fulcher, PA-C
• Full Potential Chiropractic LLC
• David C Gaines, MD
• Matthew Gallagher, OT
• Mary Alice Gallant, PA
• Samantha Gamarra, FNP
• Maya Gapac
• Angela M Garcia, MED, RD, LD
• Danielle Gusman Garcia, M.S. CCC-SLP
• Ricardo Enrique Garcia

• Physician Assistant in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.

Verify at the official NPI Registry.