Active NPI
Alysa M Gregory, LCSW
- Clinical Social Worker
- St Augustine, FL
National Provider Identifier
1639727316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW16136
- Practice address
- 9 San Bartola Dr
St Augustine, FL 32086-5767 - Phone
- (904) 825-4500
- Fax
- (904) 825-3672
- NPI assigned
- Aug 27, 2019
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW16136 | FL | Primary |
Addresses
Primary practice location
9 San Bartola Dr
St Augustine, FL 32086-5767
Mailing address
7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LU495 | Other | FL | MEDICARE |
| 882F4 | Other | FL | FL BLUE |
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: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Interoperability endpoints
- alysagregory@tdh.allscriptsdirect.net
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1639727316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 A C SKINNER PKWY STE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566932",
"telephone_number": "904-363-2113",
"fax_number": "904-363-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 SAN BARTOLA DR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865767",
"telephone_number": "904-825-4500",
"fax_number": "904-825-3672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "ALYSA",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW16136",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "LU495",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL BLUE",
"identifier": "882F4",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.