Individual provider Active NPI

Gregory Paul Gamache, D.C.

  • Chiropractor
  • Soddy Daisy, TN
National Provider Identifier
1376627455
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1885 Issued in TN
Practice address
8301 Dayton Pike
Soddy Daisy, TN 37379-4202
Phone
(423) 842-2828
Fax
(423) 842-1688
NPI assigned
Oct 25, 2006
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1885 TN Primary

Addresses

Primary practice location

8301 Dayton Pike
Soddy Daisy, TN 37379-4202

Mailing address

8301 Dayton Pike
Soddy Daisy, TN 37379-4202
Phone (423) 842-2828

Other identifiers 4

IdentifierTypeStateIssuer
4051204OtherTNBLUE CROSS BLUE SHIELD
7582414OtherTNAETNA ID
P00030062OtherTNPALMETTO MEDICARE RAILROA
0624970OtherTNCIGNA ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111118000117 TN Practitioner - Chiropractic 9638380488 Practice locations: Soddy Daisy, TN
I20240325000226 GA Practitioner - Chiropractic 9638380488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Ford Chiropractic Inc.Group PAC ID 6507272036, 2 clinicians

Practice addresses (Care Compare)

1304 N Main St
La Fayette, GA 30728-2137
Phone (706) 639-3333

1304 N Main St
La Fayette, GA 30728-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1885TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ford Chiropractic Inc. Chiropractor CurrentSince Feb 5, 2024 Accepting new patients
Back2Health Chiropractic TN LLC PastSince Oct 13, 2024 Accepting new patients

Locations

1304 N Main St
La Fayette, GA 30728
Phone (706) 639-3333

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1376627455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794202",
            "telephone_number": "423-842-2828",
            "fax_number": "423-842-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794202",
            "telephone_number": "423-842-2828",
            "fax_number": "423-842-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMACHE",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4051204",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "7582414",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO MEDICARE RAILROA",
            "identifier": "P00030062",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "0624970",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.