Active NPI
Carrie L Gregory, DENTAL HYGENTIST
- Dental Hygienist
- New Madrid, MO
National Provider Identifier
1629196944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2003003714
- Practice address
- 202B Main St
New Madrid, MO 63869-1911 - Phone
- (573) 748-5671
- Fax
- (573) 748-5317
- NPI assigned
- Mar 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2003003714 | MO | Primary |
Addresses
Primary practice location
202B Main St
New Madrid, MO 63869-1911
Mailing address
202B Main St
P.O. Box 400
New Madrid, MO 63869-1911
Phone (573) 748-5671
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003003714 | MO | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Missouri Health Network | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Bootheel Dental Clinic
- Federally Qualified Health Center (FQHC)
- New Madrid, MO
- NPI 1457570681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629196944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202B MAIN ST",
"address_2": "P.O. BOX 400",
"city": "NEW MADRID",
"state": "MO",
"postal_code": "638691911",
"telephone_number": "573-748-5671",
"fax_number": "573-748-5317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202B MAIN ST",
"city": "NEW MADRID",
"state": "MO",
"postal_code": "638691911",
"telephone_number": "573-748-5671",
"fax_number": "573-748-5317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "CARRIE",
"middle_name": "L",
"credential": "DENTAL HYGENTIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2003003714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Madrid, MO
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- Family Matters in Home LLC
- Ferguson Medical Group Rural Health Center, Inc
- Kelly Ann Fiala, MOTR/L
- Freds Stores of Tennessee Inc (Freds Pharmacy 3710)
- Christine Grissom
- Guardian Home Health Care LLC
- Health Facilities Rehab Services Inc
- Heart2Help
- Charlotte Ann Hogan, SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.