Individual provider Active NPI

Gregory Paul Nishida, D.C.

  • Sports Physician Chiropractor
  • Newport Beach, CA
National Provider Identifier
1104957554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC20722 Issued in CA
Practice address
20250 SW Acacia St
Suite #150
Newport Beach, CA 92660-1735
Phone
(949) 851-2225
Fax
(949) 851-2281
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC20722 CA Primary

Addresses

Primary practice location

20250 SW Acacia St
Suite #150
Newport Beach, CA 92660-1735

Mailing address

20250 SW Acacia St
Suite #150
Newport Beach, CA 92660-1735
Phone (949) 851-2225

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

LicenseStateTypeSpecialty
DC20722CAMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104957554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20250 SW ACACIA ST",
            "address_2": "SUITE #150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601735",
            "telephone_number": "949-851-2225",
            "fax_number": "949-851-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20250 SW ACACIA ST",
            "address_2": "SUITE #150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601735",
            "telephone_number": "949-851-2225",
            "fax_number": "949-851-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIDA",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC20722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

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.

Verify at the official NPI Registry.