Jody A Gallaway, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2319-057 Issued in WI

Practice address

1011 N 8TH St
Sheboygan, WI 53081-4006

Phone

(920) 459-3155

Fax

(920) 459-4353

NPI assigned

May 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of SheboyganGroup PAC ID 2567568918, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Sheboygan

  • Community/Behavioral Health Agency
  • Sheboygan, WI
  • NPI 1477677615
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1689625485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814006",
            "telephone_number": "920-459-3207",
            "fax_number": "920-459-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814006",
            "telephone_number": "920-459-3155",
            "fax_number": "920-459-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAWAY",
        "first_name": "JODY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2319-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39134800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy J Gainey, DDS
• Lisa L Gajewski, MS, OTR
• Margaret Galaska, COTA
• Henry H Gale, MD
• Catherine Ann Gallagher, LPC
• Badri N Ganju, MD
• Gary R Scherr, MD
• Michelle Rose Gasper
• Kevin J Gassner, MD
• Kyle R Gassner, M.D.

• Clinical Psychologist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.