Individual provider Active NPI

Tara Nichole Galloway, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1629516455
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017001488 Issued in MO
Practice address
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 617-2000
NPI assigned
Jan 31, 2017
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017001488 MO Primary

Addresses

Primary practice location

1201 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-9123

Other practice location 1

400 S Kingshighway Blvd
Dept Emergency Med
Saint Louis, MO 63110-1014
Phone (314) 362-9123

Other identifiers 1

IdentifierTypeStateIssuer
420040530MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170424000766 MO Practitioner - Nurse Practitioner 8820374044 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Surgical Specialists LLCGroup PAC ID 1153455076, 180 clinicians
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 406
Saint Louis, MO 63128-2197
Phone (314) 525-1224

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5641

400 S Kingshighway Blvd
Saint Louis, MO 63110-1014
Phone (314) 454-7900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Surgical Specialists, LLC CurrentSince Aug 1, 2022 Accepting new patients
Washington University CurrentSince May 1, 2017 Accepting new patients
SSM Health Care Group CurrentSince Oct 1, 2025 Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Mar 5, 2020 Accepting new patients
SSM Health Care Group CurrentSince Oct 1, 2025 Accepting new patients
Cep America LLC CurrentSince Mar 5, 2020 Accepting new patients
Washington University CurrentSince May 1, 2017 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Mercy Clinic East Communities Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128
Phone (314) 525-1224

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

400 S Kingshighway Blvd
#F
Saint Louis, MO 63110
Phone (314) 454-7900

621 S New Ballas Rd
Ste 3005B
Saint Louis, MO 63141
Phone (314) 251-7070

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

660 S Euclid Ave
#8072
Saint Louis, MO 63110
Phone (314) 362-9177

660 S Euclid Ave
#C
Saint Louis, MO 63110

851 E 5th St
Ste 108
Washington, MO 63090
Phone (636) 239-4144

Interoperability endpoints

  • Direct secure messaging: tgalloway306623@direct-ehr-ssmhc.com

Organizations & group practices 10

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1629516455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-617-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Med",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101014",
            "country_code": "US",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "TARA",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017001488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420040530",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.