Individual provider Active NPI

Gregory Frank Altman, MD

  • Military Health Care Provider
  • Joint Base Lewis McChord, WA
National Provider Identifier
1639800295
Registry record updated Sep 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
Practice address
9040 Jackson Ave Tacoma Wa 98431
Joint Base Lewis McChord, WA 98431-0001
Phone
(253) 968-3066
Fax
(253) 968-0384
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X Primary

Addresses

Primary practice location

9040 Jackson Ave Tacoma Wa 98431
Joint Base Lewis McChord, WA 98431-0001

Mailing address

9040 Jackson Ave Tacoma Wa 98431
Joint Base Lewis McChord, WA 98431-0001
Phone (253) 968-3066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231116001830 GA Order and Referring Only - Family PracticePractitioner - Family Practice 6507213204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1639800295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE TACOMA WA 98431",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3066",
            "fax_number": "253-968-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE TACOMA WA 98431",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3066",
            "fax_number": "253-968-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "GREGORY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joint Base Lewis McChord, WA

Sources for this page

Verify at the official NPI Registry.