Phillip Kenneth Gregoire, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

MD.MD.61252337 Issued in WA

Practice address

12728 19TH Ave SE Ste 300
Everett, WA 98208-6526

Phone

(425) 791-3084

NPI assigned

Feb 18, 2022

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

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

Locations

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.

• Western Washington Medical Group, Inc PS

  • Otolaryngology Physician
  • Everett, WA
  • NPI 1285852681

  Single Specialty

  NPD
• Western Washington Medical Group, Inc PS

  • Psychiatry Physician
  • Everett, WA
  • NPI 1396413803

  Single Specialty

  NPD
• Western Washington Medical Group, Inc PS

  • Infectious Disease Physician
  • Everett, WA
  • NPI 1427816305
  NPD

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1073268827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-791-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12728 19TH AVE SE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086526",
            "telephone_number": "425-791-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGOIRE",
        "first_name": "PHILLIP",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD.MD.61252337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deidre Michelle Greene
• Leslie A Greene, M.D.
• Kali Lila-Rose Greenhalgh
• Stephen Kelly Greenhouse, PSY.D.
• Tammy Greer
• Vanessa Victoria Gregorius, OD
• Gregory a Hanson DDS PS
• Susan Gregory
• Thomas W Greisamer, M.D.
• McKenzie Marie Grenz

• Critical Care Medicine (Internal Medicine) Physician in Everett, WA
• Providers in Everett, WA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.