NPIMap

Organization Active NPI

Gregam PLLC

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1558070284
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GREGAM PLLC
Practice address
4222 Trinity Mills Rd Ste 250
Dallas, TX 75287-7655
Phone
(818) 939-2159
NPI assigned
Nov 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Tracy Teimourian, LCSWNPI 1639419351
Title
Owner
Phone
(818) 939-2159

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4222 Trinity Mills Rd Ste 250
Dallas, TX 75287-7655

Mailing address

4222 Trinity Mills Rd Ste 250
Dallas, TX 75287-7655

Other names 1

  • Ellie Mental Health-Carrollton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230414000590 TX Part B Supplier - Clinic/Group Practice 6002281565 Receives reassigned benefits from 7 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1558070284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 TRINITY MILLS RD STE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 TRINITY MILLS RD STE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877655",
            "telephone_number": "818-939-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGAM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "TEIMOURIAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-939-2159",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health-Carrollton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.