Individual provider Active NPI

Katelyn Galloway Phillips, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1730813965
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5016727 Issued in NC
Practice address
1781 Tate Blvd SE Ste 202
Hickory, NC 28602-4252
Phone
(828) 758-1320
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 5016727 NC Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 5016727 NC

Addresses

Primary practice location

1781 Tate Blvd SE Ste 202
Hickory, NC 28602-4252

Mailing address

103 Trexler Ave
Mount Holly, NC 28120-2433
Phone (704) 840-8795

Other names 1

  • Miss Katelyn Elizabeth Galloway Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240810000223 NC Practitioner - Nurse Practitioner 9234674391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5016727NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Multi-Specialty CurrentSince Aug 12, 2024 Accepting new patients
Theoria Medical Multi-Specialty Past Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

969 Cox Rd
Gastonia, NC 28054
Phone (704) 266-8596

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

1010 Lakeview Dr
Pineville, NC 28134
Phone (704) 889-2273

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1730813965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TREXLER AVE",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281202433",
            "telephone_number": "704-840-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 TATE BLVD SE STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024252",
            "telephone_number": "828-758-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KATELYN",
        "middle_name": "GALLOWAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016727",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "GALLOWAY",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.