Active NPI
Stephen Gregory, LAC
- Acupuncturist
- Portland, OR
National Provider Identifier
1205173671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC159857
- Practice address
- 3710 SW U.S. Veteran's Hospital Rd
Portland, OR 97239 - Phone
- (503) 220-8262
- NPI assigned
- Jan 5, 2013
- Last updated
- Dec 18, 2024
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC159857 | OR | Primary |
Addresses
Primary practice location
3710 SW U.S. Veteran's Hospital Rd
Portland, OR 97239
Mailing address
3710 SW U.S. Veteran's Hospital Rd
Attn: Stephen Gregory Cp3Anes
Portland, OR 97239
Phone (503) 893-5711
Other names 1
- Stephanie Grant
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 |
|---|---|---|---|
| AC159857 | OR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Acupuncture LLC | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Acupuncturist
- Portland, OR
- NPI 1053961698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1205173671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 SW U.S. VETERAN'S HOSPITAL RD",
"address_2": "ATTN: STEPHEN GREGORY CP3ANES",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-893-5711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW U.S. VETERAN'S HOSPITAL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-220-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "STEPHEN",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-05",
"last_updated": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC159857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "GRANT",
"credential": "L.AC.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.