KENNETH RAYNOR GALLUP JR.


Address: 100 Chatham Medical Park, Elkin, NC 28621-2445
Phone: 3365277198

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NC 34396 05

Office Location

Street Address 100 CHATHAM MEDICAL PARK
City ELKIN
State NC
Zip Code 28621-2445

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205061256 Hugh Chatham Memorial Hospital, Inc Internal Medicine 520 Chatham Medical Park, Elkin, NC 28621 2009-05-20

Providers in the same taxonomy and state

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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Competitor

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City ELKIN
Zip Code 28621

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Dataset Information

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.

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