Individual provider Active NPI

Fred Marshall Gregg III, M.D.

  • Ophthalmology Physician
  • Chattanooga, TN
National Provider Identifier
1043394968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD012037 Issued in TN
Practice address
725 Glenwood Dr
Suite 892
Chattanooga, TN 37404-1163
Phone
(423) 624-3937
Fax
(423) 629-6505
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD012037 TN Primary

Addresses

Primary practice location

725 Glenwood Dr
Suite 892
Chattanooga, TN 37404-1163

Mailing address

725 Glenwood Dr
Suite 892
Chattanooga, TN 37404-1163
Phone (423) 624-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040612000272 TN Practitioner - Ophthalmology 4587647102 Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD012037TNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Vision Center, PLC Ophthalmology CurrentSince Mar 1, 2013 Accepting new patients
Memorial Health Partners Foundation Inc Past Accepting new patients

Locations

2158 Northgate Park Ln
Ste 302
Chattanooga, TN 37415
Phone (423) 870-4900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043394968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 892",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-624-3937",
            "fax_number": "423-629-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE 892",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-624-3937",
            "fax_number": "423-629-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "FRED",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD012037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.