Organization Active NPI

Dr Stephen R Gregory & Assoc, PC

  • Optometrist
  • Washington, IN
National Provider Identifier
1235237249
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR STEPHEN R GREGORY & ASSOC, PC
Practice address
400 E National Hwy
Washington, IN 47501-4114
Phone
(812) 254-1276
Fax
(812) 254-4099
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Authorized official

Name
Dr. Stephen R Gregory, O.D.NPI 1184605982
Title
President
Phone
(812) 254-1276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

400 E National Hwy
Washington, IN 47501-4114

Mailing address

PO Box 798
Washington, IN 47501-0798
Phone (812) 254-1276

Other identifiers 1

IdentifierTypeStateIssuer
200046290AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100729000646 IN Part B Supplier - Clinic/Group Practice 6406989359 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275955200000",
    "number": "1235237249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010798",
            "telephone_number": "812-254-1276",
            "fax_number": "812-254-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E NATIONAL HWY",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014114",
            "telephone_number": "812-254-1276",
            "fax_number": "812-254-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR STEPHEN R GREGORY & ASSOC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-06-08",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-254-1276",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046290A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.