Individual provider Active NPI

Tara Galles, OTR

  • Occupational Therapist
  • Kokomo, IN
National Provider Identifier
1497228126
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31003312A Issued in IN
Practice address
1802 Cadillac Dr E
Kokomo, IN 46902-2538
Phone
(765) 319-8420
NPI assigned
Jan 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31003312A IN Primary

Addresses

Primary practice location

1802 Cadillac Dr E
Kokomo, IN 46902-2538

Mailing address

1802 Cadillac Dr E
Kokomo, IN 46902-2538
Phone (765) 319-8420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190205001033 IN Practitioner - Occupational Therapist in Private Practice 9830437557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shmily Productions LLCGroup PAC ID 5092051672, 2 clinicians

Practice addresses (Care Compare)

1542 S Dixon Rd B
You'Re in Control!
Kokomo, IN 46902-7319
Phone (765) 319-8420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1497228126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 CADILLAC DR E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022538",
            "telephone_number": "765-319-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 CADILLAC DR E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022538",
            "telephone_number": "765-319-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLES",
        "first_name": "TARA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003312A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.