Gregg E Davis MD LTD

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036-058885 Issued in IL

Legal business name

GREGG E DAVIS MD LTD

Practice address

204 Park Ave E
Princeton, IL 61356-2114

Phone

(815) 879-3212

Fax

(815) 879-8602

NPI assigned

Jul 31, 2009

Last updated

Jul 31, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregg E Davis, MDNPI 1306887674

Title

Ceo

Phone

(815) 879-3212

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregg E Davis, MD

  • Family Medicine Physician
  • Princeton, IL
  • NPI 1306887674
  Authorized official Same address or phone

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1447481908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562114",
            "telephone_number": "815-879-3212",
            "fax_number": "815-879-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562114",
            "telephone_number": "815-879-3212",
            "fax_number": "815-879-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGG E DAVIS MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-879-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036-058885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goldwater Care Princeton LLC (Goldwater Care Princeton)
• Goldwater Care Princeton LLC (Goldwater Care Princeton)
• Gorenz Counseling and Consulting LTD
• David Gorenz
• Shelley Gorenz, :LCPC LSW
• Sara Elizabeth Grieff, PT, DPT
• H2Mi Design Build
• Hawthorne Inn Supportive Living Facility
• Healing Hands Resource Center (healing hands resource center princeton)
• Mark Horwitz, LCSW CADC

• Primary Care Clinic/Center in Princeton, IL
• Providers in Princeton, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.