KENNETH RAYNOR GALLUP JR. (NPI# 1306828538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306828538 |
Entity Type | Individual |
Full Name | KENNETH RAYNOR GALLUP JR. |
Credential | MD |
Practice Address |
100 Chatham Medical Park Elkin NC 28621-2445 |
Mailing Address |
3001 Lyndhurst Ave Winston Salem NC 27103 |
Practice Telephone | 3365277198 |
Practice Fax Number | 3365278379 |
Mailing Telephone | 3367650383 |
Mailing Fax Number | 3367681737 |
Enumeration Date | 2005-11-15 |
Last Update Date | 2016-08-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
18642 | NC | Allopathic & Osteopathic Physicians |
N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
18642 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 34396 | 05 |
Street Address |
100 CHATHAM MEDICAL PARK |
City | ELKIN |
State | NC |
Zip Code | 28621-2445 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992126403 | Hugh Chatham Memorial Hospital, Inc | Psychiatry & Neurology | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2013-12-31 |
1033344080 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 100 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
1083859458 | Hugh Chatham Memorial Hospital | Internal Medicine | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2008-12-12 |
1053597856 | Hugh Chatham Memorial Hospital Inc | Urology | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2008-01-11 |
1578785960 | Piedmont Foot & Ankle Associates, P.C. | Podiatrist | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2007-05-03 |
1386667343 | Robert S Meadows | Psychiatry & Neurology | 100 Chatham Medical Park, Elkin, NC 28621-2445 | 2006-07-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013553692 | Carenet, Inc. | Counselor | 1288 C.b. Eller School Road, Elkin, NC 28621 | 2019-11-19 |
1386104776 | North Bridge Physio and Sports Performance | Clinic/Center | 1605 North Bridge Street, Elkin, NC 28621 | 2019-03-21 |
1609389238 | Rebecca Anne Dumas | Physical Therapist | 145 Valleybrook Dr, Elkin, NC 28621 | 2017-11-06 |
1922547744 | Lori Barker | Clinical Nurse Specialist | 124, Samaritan's Ridge Road, Elkin, NC 28621 | 2017-02-13 |
1205061256 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 520 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
1093909236 | Elkin Obstetrics and Gynecology, Pllc | Obstetrics & Gynecology | 101 A Eldon Parks Dr., Elkin, NC 28621 | 2007-08-30 |
1497956205 | Nayana Abrol | Internal Medicine | 180 Parkwood Drive, Hugh Chatham Memorial Hospital, Elkin, NC 28621 | 2007-05-30 |
1104950765 | Dgis Elkin Inc Dba Chatham Nursing and Rehabilitation | Skilled Nursing Facility | 700 Johnson Ridge Road, Elkin, NC 28621 | 2007-03-15 |
1093860777 | Carolina Select Home Care, LLC. | Home Health | 948-b Johnson Ridge Rd., Elkin, NC 28621 | 2007-01-24 |
1922160761 | Piedmont Department of Urology, Pllc | Urology | 350 Johnson Ridge Medical Park, Elkin, NC 28621 | 2006-12-15 |
Find all providers in zip 28621 |
Taxonomy Code | 207RC0200X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Critical Care Medicine |
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205061256 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 520 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114411139 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 202, Charlotte, NC 28215-7072 | 2018-06-22 |
1134548811 | Trevor Taylor | Internal Medicine | 3000 New Bern Ave Ste 1140, Raleigh, NC 27610-1231 | 2014-04-10 |
1114268042 | Advanced Respiratory and Sleep Medicine, Pllc | Internal Medicine | 36 14th Ave Ne Ste 103, Hickory, NC 28601-2581 | 2013-03-01 |
1205173184 | Novant Medical Group Inc | Internal Medicine | 1630 Campus Park Dr, Unit C, Monroe, NC 28112-5269 | 2013-01-11 |
1295072171 | Novant Medical Group Inc | Internal Medicine | 8540 E Independence Blvd, Charlotte, NC 28227-7783 | 2013-01-11 |
1639443617 | Novant Medical Group Inc | Internal Medicine | 8629 Jm Keynes Dr, Charlotte, NC 28262-8425 | 2012-03-08 |
1184852105 | Carolinas Physicians Network, Inc. | Internal Medicine | 52 Hospital Dr, Suite 3-a, Columbus, NC 28722-8516 | 2009-06-29 |
1144477837 | Union Physicians Network Inc | Internal Medicine | 1428 Ellen Street, Suite B, Monroe, NC 28112-5286 | 2008-08-25 |
1013171735 | Thomas J Bice | Internal Medicine | 1969 Wellness Blvd, Monroe, NC 28110-7763 | 2008-07-11 |
1568621332 | Adam Richard Belanger | Internal Medicine | Cb 7020 130 Mason Farm Rd, 4th Floor Bioinformatics Bldg, Chapel Hill, NC 27599-0001 | 2008-06-05 |
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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.