Gregory Aaron Andis, M.S., LAT, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2089219 Issued in TX

Practice address

2525 N Grandview Ave
Suite 400
Odessa, TX 79761-1600

Phone

(432) 550-4700

Fax

(432) 550-4715

NPI assigned

Feb 16, 2007

Last updated

Mar 22, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1629112693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 HAWAII CV",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797624909",
            "telephone_number": "432-553-3131",
            "fax_number": "432-550-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE",
            "address_2": "SUITE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611600",
            "telephone_number": "432-550-4700",
            "fax_number": "432-550-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDIS",
        "first_name": "GREGORY",
        "middle_name": "AARON",
        "credential": "M.S., LAT, ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT 1622",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2089219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Hannah Anderson
• Charlotte Anderson
• Errol Claude Anderson, M.D.
• Wesley Dale Anderson, L.S.A.
• Andes Dental PLLC (Odessa Family Dental)
• Grace Castillo Andrade, PA-C
• Liliana Coromoto Andrade, MD
• Obianuju Mercy Anelo
• Brittany Anez, FNP
• Dimitrios Angelis, M.D

• Physical Therapy Assistant in Odessa, TX
• Providers in Odessa, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.