Active NPI
Mitchell Gregg, M.D.
- Diagnostic Radiology Physician
- Village of Palmetto Bay, FL
National Provider Identifier
1366547325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME0018008
- Practice address
- 9333 SW 152ND St
Village of Palmetto Bay, FL 33157-1778 - Phone
- (305) 665-4614
- Fax
- (305) 667-0239
- NPI assigned
- Sep 14, 2006
- Last updated
- Jan 7, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | ME0018008 | FL | Primary |
Addresses
Primary practice location
9333 SW 152ND St
Village of Palmetto Bay, FL 33157-1778
Mailing address
5901 SW 74TH St
Suite 202
Miami, FL 33143-5165
Phone (305) 665-4614
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0018008 | FL | MD | Diagnostic Radiology Physician |
| 18008 | FL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Radiology LLC | Past | Accepting new patients | |
| Coral Reef Radiology Associates PA | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Village of Palmetto Bay, FL
- NPI 1972600385
-
- Radiology Clinic/Center
- Doral, FL
- NPI 1588111488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1366547325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 SW 74TH ST",
"address_2": "SUITE 202",
"city": "MIAMI",
"state": "FL",
"postal_code": "331435165",
"telephone_number": "305-665-4614",
"fax_number": "305-667-0239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9333 SW 152ND ST",
"city": "VILLAGE OF PALMETTO BAY",
"state": "FL",
"postal_code": "331571778",
"telephone_number": "305-665-4614",
"fax_number": "305-667-0239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGG",
"first_name": "MITCHELL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME0018008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Village of Palmetto Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.