Active NPI
Marisa Galavotti
- Physician Assistant
- Garner, NC
National Provider Identifier
1962761684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-03272
- Practice address
- 893 US Highway 70 W
Suite 200
Garner, NC 27529-2100 - Phone
- (919) 779-6461
- NPI assigned
- May 15, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-03272 | NC | Primary |
Addresses
Primary practice location
893 US Highway 70 W
Suite 200
Garner, NC 27529-2100
Mailing address
1405 Cane Creek Dr
Garner, NC 27529-2100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-03272 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1962761684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 CANE CREEK DR",
"city": "GARNER",
"state": "NC",
"postal_code": "275292100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "893 US HIGHWAY 70 W",
"address_2": "SUITE 200",
"city": "GARNER",
"state": "NC",
"postal_code": "275292100",
"telephone_number": "919-779-6461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALAVOTTI",
"first_name": "MARISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-15",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-03272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garner, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.