Mary Angela Cancino Gallagher, OTR/L

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

2927 Issued in NM

Practice address

304 N Richardson Ave
Roswell, NM 88201-4639

Phone

(575) 578-0069

Fax

(575) 578-0124

NPI assigned

Jun 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Angela Cancino Gallagher Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A-Z Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Rio Rancho, NM
  • NPI 1861772972
  NPD (past)

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1659633550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N RICHARDSON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014639",
            "telephone_number": "575-578-0069",
            "fax_number": "575-578-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N RICHARDSON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014639",
            "telephone_number": "575-578-0069",
            "fax_number": "575-578-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCINO GALLAGHER",
        "first_name": "MARY ANGELA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NM",
            "license": "2927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANGELA",
            "last_name": "GALLAGHER",
            "middle_name": "CANCINO",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Ballard Callaway, PA-C
• Jana Elaine Camp
• Jennifer Campbell
• Jennifer Leigh Campbell, M.S. CCC-SLP
• Ashley Ruth Canard, M.S. SLP-CFY
• Alysia Aryhanna Candelaria
• Jose Candelaria
• Capital Anesthesia Solutions of New Mexico LLC
• Jessica Carabajal
• Diana Dolores Cardenas Maldonado, MD

• All providers in Roswell, NM
• Occupational Medicine Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.