Individual provider Active NPI

Tanya Gallman

  • Renal Dialysis Technician
  • Kennesaw, GA
National Provider Identifier
1427444991
Registry record updated Apr 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Dialysis TechnicianTaxonomy code 2472R0900X
License
051389334 Issued in GA
Practice address
4155 Royal Regency Cir NW
Kennesaw, GA 30144-6476
Phone
(678) 668-9603
NPI assigned
Apr 12, 2015
Last updated
Apr 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Dialysis Technician 2472R0900X 051389334 GA Primary

Addresses

Primary practice location

4155 Royal Regency Cir NW
Kennesaw, GA 30144-6476

Mailing address

4155 Royal Regency Cir NW
Kennesaw, GA 30144-6476
Phone (678) 668-9603

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

LicenseStateTypeSpecialty
051389334GAMDRenal Dialysis Technician

NPI Registry JSON

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428796800000",
    "number": "1427444991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 ROYAL REGENCY CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446476",
            "telephone_number": "678-668-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 ROYAL REGENCY CIR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446476",
            "telephone_number": "678-668-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLMAN",
        "first_name": "TANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-12",
        "last_updated": "2015-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2472R0900X",
            "taxonomy_group": "",
            "desc": "Technician, Other, Renal Dialysis",
            "state": "GA",
            "license": "051389334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2015; 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.