Active NPI
Harry A Gallis, MD
- Internal Medicine Physician
- Charlotte, NC
National Provider Identifier
1962434894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 15477
- Practice address
- 1000 Blythe Blvd
Charlotte, NC 28203-5812 - Phone
- (704) 512-7562
- Fax
- (704) 512-7565
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 15477 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
Charlotte, NC 28203-5812
Mailing address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 512-7562
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8934385 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15477 | NC | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962434894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-512-7562",
"fax_number": "704-512-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-512-7562",
"fax_number": "704-512-7565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLIS",
"first_name": "HARRY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "15477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8934385",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.