Samuel Alexander Gallup

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

19800 Village Office CT Ste 104
Bend, OR 97702-1813

Phone

(541) 480-2570

NPI assigned

Feb 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cascade Behavioral Intervention, LLC

  • Behavior Analyst
  • Bend, OR
  • NPI 1942537444
  NPD (past)

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1952866162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21204 SE GOLDEN MARKET LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023651",
            "telephone_number": "518-727-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19800 VILLAGE OFFICE CT STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021813",
            "telephone_number": "541-480-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "SAMUEL",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Gallegos
• Rachele Gallinat
• Stacy Gallinger, LPC
• Teri Gallion
• Ryan P Gallivan, MD
• Jaclyn Gamboa, PT
• Ryan Gamlin, MD
• Gene Gammond
• Erik Muse Gantt, LPC, CADC I
• Taylor Kenzie Garagiola

• Behavior Technician in Bend, OR
• Providers in Bend, OR by specialty
• Behavior Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.