Shawn Patrick Gallagher, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP9995 Issued in AZ

Practice address

2587 N Beverly PL
Buckeye, AZ 85396-1793

Phone

(210) 380-2107

NPI assigned

Jul 15, 2006

Last updated

May 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgallagher305134@direct.emplifyhealth.org

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.

• SPG PM2 Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Buckeye, AZ
  • NPI 1669110623
  NPD Authorized official
• Connectionsaz, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1083840953
  NPD
• Connectionsaz, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1972985547
  NPD
• Notre Dame Behavioral Health, PLLC

  • Psychiatry Physician
  • Surprise, AZ
  • NPI 1356749543
  NPD
• Satinder S. Purewal, M.D. LLC

  dba Sahara Behavioral Health

  • Psychiatry Physician
  • Glendale, AZ
  • NPI 1528128311
  NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• M Ruth Infante MD PC

  • Psychiatry Physician
  • Alexandria, VA
  • NPI 1043615057
  NPD (past)
• Skyline Psychiatric Associates Inc

  • Psychiatry Physician
  • Alexandria, VA
  • NPI 1093758278
  NPD (past)
• Valdez & Soto, LLC

  dba Alay Health Team

  • Psychiatric/Mental Health Nurse Practitioner
  • Pewaukee, WI
  • NPI 1114377702
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1710903281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 N BEVERLY PL",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961793",
            "telephone_number": "210-380-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2587 N BEVERLY PL",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961793",
            "telephone_number": "210-380-2107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1846 E Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oro Valley",
            "state": "AZ",
            "postal_code": "857551963",
            "country_code": "US",
            "telephone_number": "520-771-0555",
            "fax_number": "262-260-9109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "SHAWN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN206577",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8879",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "8879",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP9995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241932",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fresh Start Bone and Joint Institue
• Marie Ellen Fritz, MA-CCC-SLP
• Harrison Daniel Fryberg, D.D.S.
• Amber Renee Gaines
• Marina Galindo
• Miriam Gallifant, OTR/L
• Estefani Munoz Garcia
• Ivan Garcia
• Nicole Garcia
• Lynn Marie Gardner, LMT

• Psychiatric/Mental Health Nurse Practitioner in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.