Active NPI
Stephanie Ann Gallaher, ARNP
- Family Nurse Practitioner
- Coeur d'Alene, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 73290
- Practice address
- 315 W Dalton Ave Ste B
Coeur D Alene, ID 83815-8600 - Phone
- (208) 209-2066
- Fax
- (208) 209-2076
- NPI assigned
- Nov 28, 2005
- Last updated
- Dec 5, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 73290 | ID | Primary |
Addresses
Primary practice location
315 W Dalton Ave Ste B
Coeur D Alene, ID 83815-8600
Mailing address
1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2498
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508849290 | Medicaid | ID |
Other names 1
- Stephanie Wallace
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7600 N Mineral Dr
Suite 450
Coeur D Alene, ID 83815-7709
Phone (208) 457-4208
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Idaho Day Surgery LLC | Current | Accepting new patients | |
| Davenport Medical Center LLC | Past | Accepting new patients | |
| North Idaho Day Surgery LLC | Past | Accepting new patients |
Locations
315 W Dalton Ave
Ste B
Coeur D Alene, ID 83815
Phone (208) 209-2066
7600 N Mineral Dr
Ste 450B
Coeur D Alene, ID 83815
Phone (208) 209-2066
7600 N Mineral Dr
Ste 450
Dalton Gardens, ID 83815
Phone (208) 457-4208
1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300
750 N Syringa St
Ste 100
Post Falls, ID 83854
Phone (208) 262-2600
Interoperability endpoints
- sgallaher@nwsh.gwaydirect.com
Organizations & group practices 3
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.
-
dba Northwest Specialty Hospital
- General Acute Care Hospital
- Post Falls, ID
- NPI 1104824739
-
- Primary Care Clinic/Center
- Coeur d'Alene, ID
- NPI 1942124995
-
- Internal Medicine Physician
- Davenport, FL
- NPI 1144306036
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Eden Home Health
- Home Health Agency
- Ponderay, ID
- NPI 1346898830
-
- Community Based Hospice Care Agency
- Coeur d'Alene, ID
- NPI 1245235878
-
- General Acute Care Hospital
- Coeur d'Alene, ID
- NPI 1992798409
-
dba Northwest Specialty Hospital
- General Acute Care Hospital
- Post Falls, ID
- NPI 1104824739
-
- Sleep Medicine (Psychiatry & Neurology) Physician
- Post Falls, ID
- NPI 1649123589
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1508849290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1593 E POLSTON AVE",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838545326",
"telephone_number": "208-262-2498",
"fax_number": "208-262-7461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 W DALTON AVE STE B",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838158600",
"telephone_number": "208-209-2066",
"fax_number": "208-209-2076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAHER",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-28",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ID",
"license": "73290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508849290",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "WALLACE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Coeur d'Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.