Gregg Phillips Standage, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD22289 Issued in AZ

Practice address

1515 S 20TH Ave
Safford, AZ 85546-4009

Phone

(928) 348-1370

Fax

(928) 348-1375

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gregg P Standage MD

  • Specialist
  • Prescott, AZ
  • NPI 1235416918
  NPD (past) Authorized official
• Gregg P Standage MD

  • Specialist
  • Safford, AZ
  • NPI 1669495537
  NPD (past) Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1063443273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S REAY LN",
            "city": "THATCHER",
            "state": "AZ",
            "postal_code": "855525417",
            "telephone_number": "928-428-0144",
            "fax_number": "928-348-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464009",
            "telephone_number": "928-348-1370",
            "fax_number": "928-348-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDAGE",
        "first_name": "GREGG",
        "middle_name": "PHILLIPS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "MD22289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356586",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Safford, AZ
• Providers in Safford, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.