Individual provider Active NPI

Thomas Galli, D.C.

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1578575825
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-007665 Issued in IL
Practice address
6080 Elaine Drive
Rockford, IL 61108
Phone
(815) 398-0880
Fax
(815) 398-9466
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-007665 IL Primary

Addresses

Primary practice location

6080 Elaine Drive
Rockford, IL 61108

Mailing address

6080 Elaine Drive
Rockford, IL 61108
Phone (815) 398-0880

Other identifiers 1

IdentifierTypeStateIssuer
05623778OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520001153 IL Practitioner - Chiropractic 0446241186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Ryan Health, IncGroup PAC ID 4880065721, 2 clinicians

Practice addresses (Care Compare)

6080 Elaine Dr
Rockford, IL 61108-3006
Phone (815) 398-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007665ILMDChiropractor

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1578575825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 ELAINE DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-398-0880",
            "fax_number": "815-398-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 ELAINE DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "815-398-0880",
            "fax_number": "815-398-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLI",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-007665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05623778",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.