Jena Nicole Gallego, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3016939 Issued in KY

Practice address

541 Buttermilk Pike Ste 100
Crescent Springs, KY 41017-1689

Phone

(859) 212-0333

NPI assigned

Oct 20, 2021

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jena Nicole Richter Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: j.richter@medimorph.com
• Direct secure messaging: jena@agelesscenter.net

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1790448280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 BUTTERMILK PIKE STE 100",
            "city": "CRESCENT SPRINGS",
            "state": "KY",
            "postal_code": "410171689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 BUTTERMILK PIKE STE 100",
            "city": "CRESCENT SPRINGS",
            "state": "KY",
            "postal_code": "410171689",
            "telephone_number": "859-212-0333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 Moore Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405032918",
            "country_code": "US",
            "telephone_number": "859-335-1330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLEGO",
        "first_name": "JENA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016939",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "379209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jena@agelesscenter.net",
            "affiliation": "N",
            "address_1": "149 Moore Dr",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405032918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "j.richter@medimorph.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "541 Buttermilk Pike Ste 100",
            "city": "Crescent Springs",
            "state": "KY",
            "country_code": "US",
            "postal_code": "410171689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENA",
            "last_name": "RICHTER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Crescent Springs, KY
• Providers in Crescent Springs, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.