Individual provider Active NPI

Jenifer Ashley Gregory, PSY.D., HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1306202932
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043124A Issued in IN
Practice address
2620 Kessler Boulevard East Dr Ste 235
Indianapolis, IN 46220-2897
Phone
(317) 762-8084
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043124A IN Primary

Addresses

Primary practice location

2620 Kessler Boulevard East Dr Ste 235
Indianapolis, IN 46220-2897

Mailing address

2620 Kessler Boulevard East Dr Ste 235
Indianapolis, IN 46220-2897
Phone (574) 274-4827

Other practice location 1

859 Willard St
Quincy, MA 02169-7482
Phone (617) 847-1926

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

LicenseStateTypeSpecialty
20043124AINMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306202932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 KESSLER BOULEVARD EAST DR STE 235",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202897",
            "telephone_number": "574-274-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 KESSLER BOULEVARD EAST DR STE 235",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202897",
            "telephone_number": "317-762-8084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "859 Willard St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021697482",
            "country_code": "US",
            "telephone_number": "617-847-1926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JENIFER",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D., HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043124A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.