Gregory C Etienne, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8320 Issued in AZ

Practice address

444 W Osborn Rd Ste 200
Phoenix, AZ 85013-3817

Phone

(480) 223-9314

Fax

(480) 923-9155

NPI assigned

Apr 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Desert Injury Group, LLC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1184508285
  NPD Authorized official
• Arizona Clinic PLLC

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1053188771
  Medicare reassignment
• Triad Pain Management Group, PLLC

  • Multi-Specialty Clinic/Center
  • Gold Canyon, AZ
  • NPI 1477802536
  Medicare reassignment
• Triad Chiropractic & Rehabilitation Clinics, LLC

  • Independent Medical Examiner Chiropractor
  • Tempe, AZ
  • NPI 1326362807
  NPD (past)

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1497384168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4834 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113610",
            "telephone_number": "480-223-9314",
            "fax_number": "480-923-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W OSBORN RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133817",
            "telephone_number": "480-223-9314",
            "fax_number": "480-923-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "GREGORY",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "154",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eternal Pathway LLC
• Eternity Home Health Care LLC
• Eternity Hospice and Palliative Care, PLLC
• Eternity Services LLC
• Cristina Rose Etienne, P.A.
• Samantha Valerie Etienne, MD
• Samuel Lucas Etling
• Ali Etman
• Saslee Etrata-Daite
• Kristal Rayne Etsitty

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.

Verify at the official NPI Registry.