EMILY GALLAWAY — NPI 1104604586 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health in WHITE CLOUD, MI)

CMS-1500 Box 24J / 33a • NPI

1104604586

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LA2200X (CMS 50)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health

Box 32 Service Location & ZIP+4

1035 E WILCOX AVE, WHITE CLOUD, MI, 49349-8794

✓ 9-Digit EDI 837 ZIP+4 (49349-8794)

Practice Phone & Referral Fax

(231) 689-5943

Fax: (231) 689-1590

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1104604586 (EMILY GALLAWAY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1104604586` (NPI-1 Individual Practitioner)
Provider / Legal Name	EMILY GALLAWAY
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health NUCC Code: `363LA2200X` (Nurse Practitioner, Adult Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1035 E WILCOX AVE, WHITE CLOUD, MI, 49349-8794
Practice Telephone / Fax	Tel: (231) 689-5943 \| Fax: (231) 689-1590
Administrative Mailing Address	520 COBB ST, CADILLAC, MI, 49601-2588
Enumeration & Last Sync	Enumerated: 2023-09-18 \| CMS Record Updated: 2023-11-27

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1035 E WILCOX AVE, WHITE CLOUD, MI, 49349-8794

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Plain-English Taxonomy & CMS Crosswalk (363LA2200X)

What Does Taxonomy Code 363LA2200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LA2200X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Nurse Practitioner, Adult Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EMILY GALLAWAY)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363LA2200X` — Nurse Practitioner, Adult Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Adult Health	State: MI \| License: `4704297341` \| Primary: Yes (Primary)
`363LG0600X` — Nurse Practitioner, Gerontology Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Gerontology	State: MI \| License: `4704297341` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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EMILY GALLAWAY (NPI #1104604586)