Active NPI
Jacqueline Helen Gallagher, OTD
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1417619099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17779
- Practice address
- 8420 University Exec Park Dr Ste 825
Charlotte, NC 28262-1346 - Phone
- (704) 727-4830
- NPI assigned
- Oct 11, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-008636 | AZ | |
| Occupational Therapist | 225X00000X | 17779 | NC | Primary |
Addresses
Primary practice location
8420 University Exec Park Dr Ste 825
Charlotte, NC 28262-1346
Mailing address
8420 University Exec Park Dr Ste 825
Charlotte, NC 28262-1346
Phone (704) 727-4830
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 |
|---|---|---|---|
| OTH-008636 | AZ | MD | Occupational Therapist |
| 17779 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774742400000",
"number": "1417619099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8420 UNIVERSITY EXEC PARK DR STE 825",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621346",
"telephone_number": "704-727-4830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8420 UNIVERSITY EXEC PARK DR STE 825",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282621346",
"telephone_number": "704-727-4830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "JACQUELINE",
"middle_name": "HELEN",
"credential": "OTD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-11",
"last_updated": "2026-03-29",
"certification_date": "2026-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-008636",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "17779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.