MS. HEIDI ANN GALLO (NPI# 1104807189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104807189 |
| Entity Type | Individual |
| Full Name | MS. HEIDI ANN GALLO |
| Credential | ARNP |
| Practice Address |
4402 Churchman Ave Suite 409 Louisville KY 40215-1190 |
| Practice Telephone | 5023689561 |
| Practice Fax Number | 5023689616 |
| Mailing Telephone | 5023689561 |
| Mailing Fax Number | 5023689616 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2015-05-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
3421P | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PASSPORT | 1161890 | 01 | |
| FEDERAL BLACK LUNG | 021102300 | 01 | |
| PASSPORT ADVANTAGE | 2439614000 | 01 | |
| ANTHEM | 000000187104 | 01 | |
| KY | MEDICARE PTAN | K075320 | 01 |
| Street Address |
4402 CHURCHMAN AVE SUITE 409 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40215-1190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164424321 | Joel Philip Garmon | Surgery | 4402 Churchman Ave, Ste 202, Louisville, KY 40215-3101 | 2005-06-01 |
| 1629523048 | Cynthia Byers | Nurse Practitioner | 4402 Churchman Ave, Suite 410, Louisville, KY 40215-1190 | 2016-08-16 |
| 1780047456 | Distler, Huntington & Blair Psc | Optometrist | 4402 Churchman Ave, Ste 306, Louisville, KY 40215-3101 | 2016-03-31 |
| 1790143295 | Julia L Staib | Nurse Practitioner | 4402 Churchman Ave, Suite 300, Louisville, KY 40215-1190 | 2016-01-29 |
| 1306218805 | Charna E Gaither | Nurse Practitioner | 4402 Churchman Ave, Suite 404, Louisville, KY 40215-1190 | 2015-10-22 |
| 1255703922 | Michelle Sims | Nurse Practitioner | 4402 Churchman Ave, Suite 302, Louisville, KY 40215-1190 | 2015-10-21 |
| 1609246156 | Elizabeth Mann Gasser | Physician Assistant | 4402 Churchman Ave, Suite 300, Louisville, KY 40215-1190 | 2015-09-28 |
| 1972907327 | Ashley Tant | Nurse Practitioner | 4402 Churchman Ave, Ste 409, Louisville, KY 40215-1190 | 2014-10-14 |
| 1417366279 | Louisville & So Indiana Pulmonary Care | Nurse Practitioner | 4402 Churchman Ave, Ste 409, Louisville, KY 40215-1190 | 2014-08-06 |
| 1447669478 | Ashley C Tant | Nurse Practitioner | 4402 Churchman Ave, Ste 409, Louisville, KY 40215-1190 | 2014-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417473315 | Robin Jones | Behavioral Analyst | 800 W. Woodlawn Ave, Louisville, KY 40215 | 2017-08-22 |
| 1316332448 | Christopher Fenzel | Emergency Medicine | 1850 Bluegrass Avenue, Louisville, KY 40215 | 2015-04-06 |
| 1447661210 | Khac Phuong Vu | Dentist | 3448 Taylor Boulevard, Louisville, KY 40215 | 2014-05-15 |
| 1619251238 | Scott H Kaminsky | Marriage & Family Therapist | 3535 Taylor Blvd, Louisville, KY 40215 | 2011-09-30 |
| 1821313529 | Taylor Blvd Chiropractic | Chiropractor | 3254 Taylor Blvd, Louisville, KY 40215 | 2010-04-06 |
| 1396985131 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4419 Lasalle Ave, Louisville, KY 40215 | 2009-03-05 |
| 1841448735 | Jewish Hospital & St. Mary's Healthcare, Inc. | Psychiatric Residential Treatment Facility | 4418 Malcolm Ave., Louisville, KY 40215 | 2008-09-04 |
| 1235329400 | Thad R. Schulten Psc | Dentist | 4515 Churchman Ave., Louisville, KY 40215 | 2007-07-25 |
| 1801911680 | Timothy John Lutes | Dentist | 3205 Taylor Blvd, Louisville, KY 40215 | 2007-03-20 |
| 1063557346 | Louisville-jefferson County Metro Government | Public Health or Welfare | 4255 Hazelwood Avenue, Louisville, KY 40215 | 2007-02-21 |
| Find all providers in zip 40215 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
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| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1699282988 | Victoria Michelle Jones | Nurse Practitioner | 7004 Austinwood Rd, Louisville, KY 40214-5930 | 2018-01-08 |
| 1295100345 | Ashley Elizabeth Summers | Nurse Practitioner | 701 Executive Park, Louisville, KY 40207 | 2015-12-01 |
| 1740608082 | Margaret Hamilton | Nurse Practitioner | 4938 Brownsboro Rd Ste 206, Louisville, KY 40222-6385 | 2014-04-03 |
| 1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
| 1356778237 | Rachel Keith-weiss | Nurse Practitioner | 580 S Preston St, Baxter II Rm 204d, Louisville, KY 40202-1756 | 2013-10-09 |
| 1598010852 | Hollis Veronica Edwards | Nurse Practitioner | 550 S Jackson St Fl 1, Louisville, KY 40202 | 2012-07-23 |
| 1578865267 | Sarah Kressy | Nurse Practitioner | 90 Health Park Dr Ste 320, Louisville, CO 80027-9742 | 2010-12-01 |
| 1780909259 | Deborah Diane Knight-williams | Nurse Practitioner | 405 Cambridge Station Rd, Wmlnc, Louisville, KY 40223-3362 | 2010-03-28 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40215 |
Please comment or provide details below to improve the information on MS. HEIDI ANN GALLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.