Active NPI
Gregory Jay Myers, M.D.
- Pediatrics Physician
- Guthrie, KY
National Provider Identifier
1194755181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 30319
- Practice address
- 10220 Dixie Beeline Highway
Guthrie, KY 42234-9310 - Phone
- (270) 220-0340
- Fax
- (270) 220-0341
- NPI assigned
- Jul 4, 2006
- Last updated
- Mar 21, 2018
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 30319 | AL | Primary |
Addresses
Primary practice location
10220 Dixie Beeline Highway
Guthrie, KY 42234-9310
Mailing address
480 Hopkinsville Street
Greenville, KY 42345-1124
Phone (270) 338-5777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100451250 | Medicaid | KY | |
| 611268014 | Other | KY | FEDERAL TAX ID# |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30319 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Vip Midsouth, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
dba VIP Children's Clinic - Pleasant View
- Rural Health Clinic/Center
- Pleasant View, TN
- NPI 1336722669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1194755181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 HOPKINSVILLE STREET",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "423451124",
"telephone_number": "270-338-5777",
"fax_number": "270-338-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10220 DIXIE BEELINE HIGHWAY",
"city": "GUTHRIE",
"state": "KY",
"postal_code": "422349310",
"telephone_number": "270-220-0340",
"fax_number": "270-220-0341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "GREGORY",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "30319",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100451250",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID#",
"identifier": "611268014",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Guthrie, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.