Individual provider Active NPI

Justin Reid Gallagher, OT

  • Occupational Therapist
  • Bowling Green, KY
National Provider Identifier
1760149314
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
245455 Issued in KY
Practice address
165 Natchez Ave
Unit 200
Bowling Green, KY 42103
Phone
(270) 796-4698
NPI assigned
Nov 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 245455 KY Primary

Addresses

Primary practice location

165 Natchez Ave
Unit 200
Bowling Green, KY 42103

Mailing address

150 Ruby Dr Apt 1a
Elizabethtown, KY 42701-4674
Phone (270) 899-0285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220107000929 KY Practitioner - Occupational Therapist in Private Practice 2163813858 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SN Kentuckiana Rehab, LLC 339 clinicians

Practice addresses (Care Compare)

190 Shadowmeade LN
Mt Washington, KY 40047-6277
Phone (502) 538-2332

210 E Gray St
Suite 807
Louisville, KY 40202-3927
Phone (502) 587-9350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC Current Accepting new patients
Kentucky Orthopedic Rehabilitation, LLC CurrentSince Feb 1, 2024 Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Feb 1, 2024 Accepting new patients
Graves Gilbert Clinic PLLC Occupational Therapist CurrentSince Dec 17, 2021 Accepting new patients
Kentucky Orthopedic Rehabilitation, LLC CurrentSince Feb 1, 2024 Accepting new patients
SN Kentuckiana Rehab, LLC Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Dec 17, 2021 Accepting new patients
SN Kentuckiana Rehab, LLC Past Accepting new patients

Locations

165 Natchez Trace Ave
Ste 200
Bowling Green, KY 42103
Phone (270) 782-7800

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

165 Natchez Trace Ave
Bowling Green, KY 42103
Phone (270) 782-7800

2618 Ring Rd
Ste 110
Elizabethtown, KY 42701
Phone (270) 230-1729

1330 N Race St
Glasgow, KY 42141
Phone (270) 629-2780

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

190 Shadowmeade Ln
Mt Washington, KY 40047
Phone (502) 538-2332

732 Vine St
Murray, KY 42071
Phone (270) 753-6477

235 Boggs Ln
Ste 9
Richmond, KY 40475
Phone (859) 972-8630

431 Adam Shepherd Pkwy
#1
Shepherdsville, KY 40165
Phone (502) 921-0272

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1760149314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 RUBY DR APT 1A",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427014674",
            "telephone_number": "270-899-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NATCHEZ AVE",
            "address_2": "UNIT 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-796-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JUSTIN",
        "middle_name": "REID",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "245455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.