Active NPI
Todd A Gregory, DC
- Chiropractor
- Pismo Beach, CA
National Provider Identifier
1104095561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC20612
- Practice address
- 855 4TH St
# 7
Pismo Beach, CA 93449-3100 - Phone
- (805) 773-3115
- Fax
- (805) 773-3116
- NPI assigned
- Feb 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC20612 | CA | Primary |
Addresses
Primary practice location
855 4TH St
# 7
Pismo Beach, CA 93449-3100
Mailing address
855 4TH St
# 7
Pismo Beach, CA 93449-3100
Phone (805) 773-3115
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 |
|---|---|---|---|
| DC20612 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1104095561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 4TH ST",
"address_2": "# 7",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "934493100",
"telephone_number": "805-773-3115",
"fax_number": "805-773-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 4TH ST",
"address_2": "# 7",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "934493100",
"telephone_number": "805-773-3115",
"fax_number": "805-773-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "TODD",
"middle_name": "A",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-29",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC20612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pismo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.