Individual provider Active NPI

Nathan Wayne Galbreath, PH.D., M.F.S.

  • Clinical Psychologist
  • Minot AFB, ND
National Provider Identifier
1467512780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04550 Issued in MD
Practice address
10 Missle Ave
5 Mdos Sgoh
Minot AFB, ND 58705-5003
Phone
(701) 723-5531
Fax
(701) 723-5525
NPI assigned
Dec 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04550 MD Primary

Addresses

Primary practice location

10 Missle Ave
5 Mdos Sgoh
Minot AFB, ND 58705-5003

Mailing address

11923 28TH Ave SW
Burien, WA 98146-2415
Phone (701) 723-5531

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
04550MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467512780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11923 28TH AVE SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462415",
            "telephone_number": "701-723-5531",
            "fax_number": "701-723-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MISSLE AVE",
            "address_2": "5 MDOS SGOH",
            "city": "MINOT AFB",
            "state": "ND",
            "postal_code": "587055003",
            "telephone_number": "701-723-5531",
            "fax_number": "701-723-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALBREATH",
        "first_name": "NATHAN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.F.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot AFB, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.