Organization Active NPI

CMG Family Wellness Center

  • Primary Care Nurse Practitioner
  • Franklin, IN
National Provider Identifier
1710309703
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
CMG FAMILY WELLNESS CENTER
Practice address
198 E Jefferson St
Franklin, IN 46131-2323
Phone
(708) 393-7538
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Authorized official

Name
Georgianne Pangallo, FNP-C
Title
FNP
Phone
(708) 393-7533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

198 E Jefferson St
Franklin, IN 46131-2323

Mailing address

6948 Windsor Ave.
Bervyn, IL 60402-3335
Phone (708) 393-7533

National Provider Directory

National Provider Directory

Locations

198 E Jefferson St
Franklin, IN 46131
Phone (317) 739-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389312000000",
    "number": "1710309703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6948 WINDSOR AVE.",
            "city": "BERVYN",
            "state": "IL",
            "postal_code": "604023335",
            "telephone_number": "708-393-7533",
            "fax_number": "708-394-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E JEFFERSON ST",
            "city": "FRANKLIN",
            "state": "IN",
            "postal_code": "461312323",
            "telephone_number": "708-393-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMG FAMILY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A",
        "authorized_official_last_name": "PANGALLO",
        "authorized_official_first_name": "GEORGIANNE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "708-393-7533",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.