Active NPI
Harley Gregory
- Home Modifications Contractor
- North Fairfield, OH
National Provider Identifier
1154730356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- Practice address
- 109 Prospect St
North Fairfield, OH 44855-9550 - Phone
- (419) 577-7896
- NPI assigned
- Aug 13, 2014
- 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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Primary |
Addresses
Primary practice location
109 Prospect St
North Fairfield, OH 44855-9550
Mailing address
109 Prospect St
North Fairfield, OH 44855-9550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3086600 | Medicaid | OH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1154730356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 PROSPECT ST",
"city": "NORTH FAIRFIELD",
"state": "OH",
"postal_code": "448559550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 PROSPECT ST",
"city": "NORTH FAIRFIELD",
"state": "OH",
"postal_code": "448559550",
"telephone_number": "419-577-7896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "HARLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-13",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3086600",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.