Mary Banks Gregerson, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810002585 Issued in VA

Practice address

1116 S Esplanade St
Leavenworth, KS 66048-3522

Phone

(913) 250-6512

Fax

(913) 250-6512

NPI assigned

Apr 19, 2007

Last updated

Jan 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1326265810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 S ESPLANADE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660483522",
            "telephone_number": "913-250-6512",
            "fax_number": "913-250-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S ESPLANADE ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660483522",
            "telephone_number": "913-250-6512",
            "fax_number": "913-250-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGERSON",
        "first_name": "MARY",
        "middle_name": "BANKS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810002585",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2011019793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Leavenworth, KS
• Providers in Leavenworth, KS by specialty
• Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.