Active NPI
John R Galloway, DDS
- Dentist
- Ellington, MO
National Provider Identifier
1487861936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7082
- Practice address
- 115 W Walnut St
Ellington, MO 63638-9300 - Phone
- (573) 663-3177
- Fax
- (573) 663-3188
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7082 | OR | Primary |
Addresses
Primary practice location
115 W Walnut St
Ellington, MO 63638-9300
Mailing address
110 S 2ND St
Ellington, MO 63638-9400
Phone (573) 663-2313
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
| License | State | Type | Specialty |
|---|---|---|---|
| D7082 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Camdenton, MO
- NPI 1588163323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518566400000",
"number": "1487861936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S 2ND ST",
"city": "ELLINGTON",
"state": "MO",
"postal_code": "636389400",
"telephone_number": "573-663-2313",
"fax_number": "573-663-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W WALNUT ST",
"city": "ELLINGTON",
"state": "MO",
"postal_code": "636389300",
"telephone_number": "573-663-3177",
"fax_number": "573-663-3188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLOWAY",
"first_name": "JOHN",
"middle_name": "R",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2018-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D7082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.