Active NPI
Roxanne B Gall, NURSE PRACTITIONER
- Nurse Practitioner
- Edgewood, KY
National Provider Identifier
1982679676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4348P
- Practice address
- 20 Medical Village Dr
Suite 394
Edgewood, KY 41017-5401 - Phone
- (859) 578-0442
- Fax
- (859) 578-9113
- NPI assigned
- Feb 17, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4348P | KY | Primary |
Addresses
Primary practice location
20 Medical Village Dr
Suite 394
Edgewood, KY 41017-5401
Mailing address
663 Nelson PL
Newport, KY 41071-1742
Phone (859) 578-0442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78013620 | Medicaid | KY |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4348P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobile Medical, Inc. | Past | Accepting new patients | |
| Cranley Surgical Associates Inc | Past | Accepting new patients | |
| Northern Kentucky Mental Health Mental Retardation Regional Board | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NorthKey Community Care
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- NPI 1578527610
-
- Surgery Physician
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- NPI 1376518845
-
- Podiatrist
- Perrysburg, OH
- NPI 1003066747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1982679676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "663 NELSON PL",
"city": "NEWPORT",
"state": "KY",
"postal_code": "410711742",
"telephone_number": "859-578-0442",
"fax_number": "859-578-9113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MEDICAL VILLAGE DR",
"address_2": "SUITE 394",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "410175401",
"telephone_number": "859-578-0442",
"fax_number": "859-578-9113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALL",
"first_name": "ROXANNE",
"middle_name": "B",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "4348P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78013620",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.