Active NPI
Gregory Alfred Nesteby, LO BOC ABC ORTHODONT
- Orthotist
- Lubbock, TX
National Provider Identifier
1093899932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- 377
- Practice address
- 2535 34TH Street
Lubbock, TX 79410 - Phone
- (806) 792-6193
- Fax
- (806) 792-2863
- NPI assigned
- Oct 25, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 377 | TX | Primary |
Addresses
Primary practice location
2535 34TH Street
Lubbock, TX 79410
Mailing address
2535 34TH Street
Lubbock, TX 79410
Phone (806) 792-6193
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 513122 | Other | TX | BCBS |
| 513122 | Other | NM | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 377 | TX | MD | Orthotist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greg a. Nesteby | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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": "1093899932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2535 34TH STREET",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79410",
"telephone_number": "806-792-6193",
"fax_number": "806-792-2863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2535 34TH STREET",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79410",
"telephone_number": "806-792-6193",
"fax_number": "806-792-2863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESTEBY",
"first_name": "GREGORY",
"middle_name": "ALFRED",
"credential": "LO BOC ABC ORTHODONT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "TX",
"license": "377",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "513122",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "513122",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.