Individual provider Active NPI

Mary Margaret Gallagher Gorman, LVN

  • Licensed Vocational Nurse
  • San Mateo, CA
National Provider Identifier
1902128754
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN 205379 Issued in CA
Practice address
147 W Hillsdale Blvd
Apt. G
San Mateo, CA 94403-4271
Phone
(650) 773-9385
NPI assigned
Feb 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN 205379 CA Primary

Addresses

Primary practice location

147 W Hillsdale Blvd
Apt. G
San Mateo, CA 94403-4271

Mailing address

147 W Hillsdale Blvd
Apt. G
San Mateo, CA 94403-4271
Phone (650) 773-9385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VN 205379CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1902128754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W HILLSDALE BLVD",
            "address_2": "APT. G",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034271",
            "telephone_number": "650-773-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W HILLSDALE BLVD",
            "address_2": "APT. G",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034271",
            "telephone_number": "650-773-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER GORMAN",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-22",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN 205379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.