Active NPI
Greg Anthony Vigna, MD
- Physical Medicine & Rehabilitation Physician
- Modesto, CA
National Provider Identifier
1376514190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- C54741
- Practice address
- 1303 Mable Ave
Modesto, CA 95355-0001 - Phone
- (209) 857-3400
- Fax
- (805) 564-3332
- NPI assigned
- Jan 30, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 1469 | SD | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 01075520A | IN | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 35141611 | OH | |
| Physical Medicine & Rehabilitation Physician | 208100000X | C54741 | CA | Primary |
| Physical Medicine & Rehabilitation Physician | 208100000X | 85785 | MT |
Addresses
Primary practice location
1303 Mable Ave
Modesto, CA 95355-0001
Mailing address
PO Box 50706
Santa Barbara, CA 93150-0706
Phone (805) 963-3757
Other practice location 1
500 15th Ave S
Great Falls, MT 59405-4324
Phone (406) 731-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201299460 | Medicaid | IN |
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 |
|---|---|---|---|
| 54741 | CA | MD | General Practice Dentistry |
| C54741 | CA | MD | Physical Medicine & Rehabilitation Physician |
| 85785 | MT | MD | Physical Medicine & Rehabilitation Physician |
| 35141611 | OH | MD | Physical Medicine & Rehabilitation Physician |
| 1469 | SD | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | 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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648166400000",
"number": "1376514190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50706",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931500706",
"telephone_number": "805-963-3757",
"fax_number": "805-564-3332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 MABLE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953550001",
"telephone_number": "209-857-3400",
"fax_number": "805-564-3332"
}
],
"practiceLocations": [
{
"address_1": "500 15th Ave S",
"address_purpose": "LOCATION",
"city": "Great Falls",
"state": "MT",
"postal_code": "594054324",
"country_code": "US",
"telephone_number": "406-731-8888",
"fax_number": "406-731-8318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VIGNA",
"first_name": "GREG",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-30",
"last_updated": "2022-03-25",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "SD",
"license": "1469",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IN",
"license": "01075520A",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OH",
"license": "35141611",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "C54741",
"primary": true
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MT",
"license": "85785",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201299460",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.