Individual provider Active NPI

Ryan Michael Galloy, MA, ATC, CSCS

  • Athletic Trainer
  • Indianapolis, IN
National Provider Identifier
1558677799
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
36001191A Issued in IN
Practice address
510 W 49TH St
Indianapolis, IN 46208-3480
Phone
(317) 940-9379
Fax
(317) 940-9967
NPI assigned
Aug 25, 2010
Last updated
Aug 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36001191A IN Primary

Addresses

Primary practice location

510 W 49TH St
Indianapolis, IN 46208-3480

Mailing address

510 W 49TH St
Indianapolis, IN 46208-3480
Phone (317) 940-9379

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
36001191AINMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1558677799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 49TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083480",
            "telephone_number": "317-940-9379",
            "fax_number": "317-940-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 49TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462083480",
            "telephone_number": "317-940-9379",
            "fax_number": "317-940-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOY",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "MA, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36001191A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.