Gahan Fallone, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2006004001 Issued in MO

Practice address

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Phone

(417) 761-5000

Fax

(417) 761-5111

NPI assigned

Apr 16, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Interoperability endpoints

• Direct secure messaging: gfallone261467@directb.mercy.net

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1669798575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLONE",
        "first_name": "GAHAN",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2006004001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669798575",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01089886",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent R Fairbanks, AA
• Jane M Fairchild, MA, LPC
• Trine Fairweather-Jensen, RD
• Annum Faisal, MD
• Ariana Fakeri
• Martin Thomas Falukos, DC
• Taylor Falukos, PHARMD
• Families First in-Home LLC
• Families Forward Counseling Services, LLC
• Family Birth and Wellness Center Inc

• Clinical Psychologist in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.