Individual provider Active NPI

Christopher Joseph Gregory, MED, ATC

  • Athletic Trainer
  • Staten Island, NY
National Provider Identifier
1083191837
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
003996 Issued in NY
Practice address
631 Howard Ave
Staten Island, NY 10301-4422
Phone
(718) 390-3100
NPI assigned
Jul 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 104.0133074 VT
Athletic Trainer 2255A2300X 0126002623 VA
Athletic Trainer 2255A2300X 003996 NY Primary

Addresses

Primary practice location

631 Howard Ave
Staten Island, NY 10301-4422

Mailing address

14 Sagebrush LN
Kings Park, NY 11754-3934
Phone (631) 873-5605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
003996NYMDFoot & Ankle Surgery Podiatrist
0126002623VAMDAthletic Trainer
104.0133074VTMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1083191837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SAGEBRUSH LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543934",
            "telephone_number": "631-873-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 HOWARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014422",
            "telephone_number": "718-390-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOSEPH",
        "credential": "MED, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-12-05",
        "certification_date": "2022-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104.0133074",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002623",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.