Individual provider Active NPI

Gregory B Melby, MD

  • Family Medicine Physician
  • The Dalles, OR
National Provider Identifier
1316929920
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD24292 Issued in OR
Practice address
1620 E 12TH St
The Dalles, OR 97058-3213
Phone
(541) 296-9151
Fax
(541) 296-9156
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD24292 OR Primary

Addresses

Primary practice location

1620 E 12TH St
The Dalles, OR 97058-3213

Mailing address

1620 E 12TH St
The Dalles, OR 97058-3213
Phone (541) 296-9151

Other identifiers 1

IdentifierTypeStateIssuer
226912MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130523000652 OR Order and Referring Only - Family PracticePractitioner - Family Practice 1557554391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24292ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1316929920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583213",
            "telephone_number": "541-296-9151",
            "fax_number": "541-296-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELBY",
        "first_name": "GREGORY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226912",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.