Peggy Grandy Gallup, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

A6793 Issued in AZ

Practice address

635 E Baseline Rd
Phoenix, AZ 85042-6551

Phone

(602) 243-7277

Fax

(602) 243-1235

NPI assigned

Feb 9, 2006

Last updated

Jul 2, 2015By 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 2

Addresses

Other identifiers 1

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.

• Banner Sun City Medical Group

  • Multi-Specialty Clinic/Center
  • Sun City, AZ
  • NPI 1902067200
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1467425579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 NORTH 3RD STREET",
            "address_2": "SUITE 4020",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044608",
            "telephone_number": "602-323-3345",
            "fax_number": "602-323-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426551",
            "telephone_number": "602-243-7277",
            "fax_number": "602-243-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "PEGGY",
        "middle_name": "GRANDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN084459",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "A6793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000037",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Galloway, PHARM.D.
• Tamara Galloway, PT
• Taryll Galloway, FNP-C
• Adrianne Gallucci, PSY.D.
• Katie Ann Gallucci
• Gallus Outpatient Services of Arizona LLC
• Shea Nicole Gallus
• Michelle Galster
• Cristina Maria Galto
• Samuel Michael Galvagno Jr., D.O.

• Women's Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Women's Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.