Individual provider Active NPI

Gregory Ray Phipps

  • Occupational Therapist
  • Jeffersonville, IN
National Provider Identifier
1376740407
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31003420A Issued in IN
Practice address
2307 Turnberry Dr
Jeffersonville, IN 47130-5094
Phone
(502) 299-9555
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31003420A IN Primary

Addresses

Primary practice location

2307 Turnberry Dr
Jeffersonville, IN 47130-5094

Mailing address

2307 Turnberry Dr
Jeffersonville, IN 47130-5094
Phone (502) 299-9555

Other identifiers 1

IdentifierTypeStateIssuer
100267020AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090626000497 IN Practitioner - Occupational Therapist in Private Practice 6305995689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holsman Physical Therapy and Rehab of Ind LLCGroup PAC ID 7214352327, 9 clinicians

Practice addresses (Care Compare)

2307 Turnberry Dr
Jeffersonville, IN 47130-5094
Phone (855) 465-7626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31003420AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holsman Physical Therapy & Rehab of Ind LLC Occupational Therapist CurrentSince Jul 14, 2020 Accepting new patients
Indiana Fitness Works Inc Occupational Therapist PastSince Oct 23, 2012 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589587200000",
    "number": "1376740407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 TURNBERRY DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305094",
            "telephone_number": "502-299-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 TURNBERRY DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305094",
            "telephone_number": "502-299-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "GREGORY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31003420A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100267020A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; 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.