Kathryn Ann Gallivan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN237322 Issued in GA

Practice address

859 Metropolitan Pkwy SW
Atlanta, GA 30310-2846

Phone

(404) 618-6983

NPI assigned

Apr 30, 2019

Last updated

Apr 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Acworth Outpatient Detox, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Acworth, GA
  • NPI 1497327720
  NPD (past)

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1427612993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 WASHINGTON BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301329098",
            "telephone_number": "404-421-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 METROPOLITAN PKWY SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102846",
            "telephone_number": "404-618-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIVAN",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Gallimore
• Sophia Gallimore
• Caroline Maurin Gallinaro, P.T.
• Jayquntai Gallion
• Lauren Marie Gallison
• Lindsay Gallo
• Lorraine Airly Gallo, RN
• Alex Patrick Galloway, MD
• James Luke Galloway
• James William Galloway

• Family Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.