Active NPI
Gregory A Wolgamott, MD
- Obstetrics & Gynecology Physician
- Longview, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD00031845
- Practice address
- 1660 Delaware St
Longview, WA 98632-2310 - Phone
- (360) 414-2800
- Fax
- (360) 414-2803
- NPI assigned
- Sep 6, 2005
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD00031845 | WA | Primary |
Addresses
Primary practice location
1660 Delaware St
Longview, WA 98632-2310
Mailing address
PO Box 249
Longview, WA 98632-7154
Phone (360) 414-2048
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65461 | Medicaid | OR | |
| 8157463 | Medicaid | WA | |
| 081333 | Other | WA | LABOR & IND. |
| 8940265 | Other | WA | CRIME VICTIMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Obstetrics & Gynecology | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
7101 NE 137th Ave
Ofc
Vancouver, WA 98682
Phone (360) 944-2700
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Obstetrics & Gynecology
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1487648432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 249",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986327154",
"telephone_number": "360-414-2048",
"fax_number": "360-575-6749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322310",
"telephone_number": "360-414-2800",
"fax_number": "360-414-2803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLGAMOTT",
"first_name": "GREGORY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WA",
"license": "MD00031845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65461",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8157463",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & IND.",
"identifier": "081333",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8940265",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.