Active NPI
Kenneth L. Galewyrick, MD
- Emergency Medicine Physician
- Polson, MT
National Provider Identifier
1588669576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 24799
- Practice address
- 6 13TH Ave E
Polson, MT 59860-5315 - Phone
- (406) 883-5680
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 24799 | WI | |
| Emergency Medicine Physician | 207P00000X | 24799 | WI | Primary |
Addresses
Primary practice location
6 13TH Ave E
Polson, MT 59860-5315
Mailing address
PO Box 262
Liberty Lake, WA 99019-0262
Phone (406) 883-5680
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30587900 | Medicaid | WI | |
| 47190 | Other | WI | MEDICARE GROUP |
| 00496 | Other | WI | MEDICARE GROUP |
| 1007586 | Other | PREFERRED ONE | |
| 080124104 | Other | PALMETTO GBA RR MEDICARE | |
| 46Q67GA | Other | BCBS MN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24799 | WI | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1588669576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 262",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190262",
"telephone_number": "406-883-5680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 13TH AVE E",
"city": "POLSON",
"state": "MT",
"postal_code": "598605315",
"telephone_number": "406-883-5680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALEWYRICK",
"first_name": "KENNETH",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "24799",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "24799",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30587900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "47190",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "00496",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1007586",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA RR MEDICARE",
"identifier": "080124104",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN",
"identifier": "46Q67GA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Polson, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.