Gregory M Grewe, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

30051-020 Issued in WI

Practice address

1789 Shawano Ave
Green Bay, WI 54303

Phone

(920) 499-1428

Fax

(920) 499-5808

NPI assigned

Jul 12, 2006

Last updated

Dec 5, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• CT Imaging LLC

  • Diagnostic Radiology Physician
  • Green Bay, WI
  • NPI 1821023961
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1306871769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033243",
            "telephone_number": "920-499-1428",
            "fax_number": "920-499-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1789 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "920-499-1428",
            "fax_number": "920-499-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWE",
        "first_name": "GREGORY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "30051-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE AMERICH",
            "identifier": "1018806004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4838144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00287110",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4838153",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31476800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Louise Greisch
• Richard H Grenell, PT
• Brock Joseph Grenier, OT
• Erin Greschner
• Shannon Gresham
• Amber Mae Griep, BSN
• Scott M Griep, MS, PA, ATC
• Sarah Marie Gries-Thomas, APNP
• Isaiah J Griesbach, D.C.
• Paige E Griesbach, RN

• Diagnostic Radiology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.