Individual provider Active NPI

Dwight Gregg Harley, PA-C

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1124091632
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
367 Issued in MT
Practice address
801 N 29TH St
Billings, MT 59101-0905
Phone
(406) 238-2500
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0311 SD
Physician Assistant 363A00000X 367 MT Primary

Addresses

Primary practice location

801 N 29TH St
Billings, MT 59101-0905

Mailing address

PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500

Other identifiers 1

IdentifierTypeStateIssuer
6825922MedicaidSD

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)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1124091632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35100",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591075100",
            "telephone_number": "406-238-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N 29TH ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591010905",
            "telephone_number": "406-238-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "DWIGHT",
        "middle_name": "GREGG",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0311",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825922",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; 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.