Individual provider Active NPI

Robin Gallagher, CRNP

  • Women's Health Nurse Practitioner
  • Old Forge, PA
National Provider Identifier
1457447203
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
TP000953B Issued in PA
Practice address
821 S Main St Ste 4
Old Forge, PA 18518-1497
Phone
(570) 457-2300
Fax
(570) 457-6627
NPI assigned
Oct 5, 2006
Last updated
Nov 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X TP000953B PA Primary
Ambulatory Women's Health Care Registered Nurse 163WW0101X TP000953B PA

Addresses

Primary practice location

821 S Main St Ste 4
Old Forge, PA 18518-1497

Mailing address

821 S Main St Ste 4
Old Forge, PA 18518-1497
Phone (570) 457-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20050801000178 PA Practitioner - Nurse Practitioner 4688602634 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TP000953BPAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 5, 2015 Accepting new patients
Geisinger Clinic CurrentSince Jan 5, 2015 Accepting new patients
Women to Women Women's Health Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3 W Olive St
Ste 201
Scranton, PA 18508
Phone (570) 961-9947

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1457447203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 S MAIN ST STE 4",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181497",
            "telephone_number": "570-457-2300",
            "fax_number": "570-457-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S MAIN ST STE 4",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181497",
            "telephone_number": "570-457-2300",
            "fax_number": "570-457-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "ROBIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "TP000953B",
            "primary": true
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "PA",
            "license": "TP000953B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Forge, PA

Sources for this page

Verify at the official NPI Registry.