Individual provider Active NPI

Kimberly Denise Galloway, PT

  • Physical Therapist
  • Maryville, TN
National Provider Identifier
1578055125
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6946 Issued in TN
Practice address
2204 Old Niles Ferry Rd
Maryville, TN 37803-8863
Phone
(865) 233-5096
NPI assigned
May 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6946 TN Primary

Addresses

Primary practice location

2204 Old Niles Ferry Rd
Maryville, TN 37803-8863

Mailing address

4854 6 Mile Rd
Maryville, TN 37803-0725
Phone (865) 856-0945

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1578055125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4854 6 MILE RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378030725",
            "telephone_number": "865-856-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 OLD NILES FERRY RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378038863",
            "telephone_number": "865-233-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT6946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.