Individual provider Active NPI

Gregory J Legris, M.D.

  • Pediatric Pulmonology Physician
  • Phoenix, AZ
National Provider Identifier
1336112192
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
20975 Issued in AZ
Practice address
500 W Thomas Rd
Suite 200
Phoenix, AZ 85013-4224
Phone
(602) 200-9159
Fax
(602) 200-9949
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 20975 AZ Primary

Addresses

Primary practice location

500 W Thomas Rd
Suite 200
Phoenix, AZ 85013-4224

Mailing address

500 W Thomas Rd Ste 220
Phoenix, AZ 85013-4215
Phone (602) 200-9159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20091230000114 AZ Practitioner - Pediatric Medicine 7719879212 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2010 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc Pediatrics Past Accepting new patients

Locations

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

Organizations & group practices 4

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1336112192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 220",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134215",
            "telephone_number": "602-200-9159",
            "fax_number": "602-200-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134224",
            "telephone_number": "602-200-9159",
            "fax_number": "602-200-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGRIS",
        "first_name": "GREGORY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "AZ",
            "license": "20975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.