Individual provider Active NPI

Mark E. Gregory, M.D.

  • Emergency Medicine Physician
  • Guthrie, OK
National Provider Identifier
1659346963
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
16492 Issued in OK
Practice address
200 S Academy Rd
Guthrie, OK 73044-8727
Phone
(405) 282-5125
NPI assigned
Feb 21, 2006
Last updated
May 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16492 OK Primary

Addresses

Primary practice location

200 S Academy Rd
Guthrie, OK 73044-8727

Mailing address

4401 W Memorial Rd
Suite 140
Oklahoma City, OK 73134-1785
Phone (405) 752-3162

Other identifiers 2

IdentifierTypeStateIssuer
100231340AMedicaidOK
020654565002OtherOKBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000650 OK Practitioner - Emergency Medicine 1951377217 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16492OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jul 2, 2012 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2015 Accepting new patients
Integris Bass Baptist Health Center Past Accepting new patients

Locations

305 S 5th St
Enid, OK 73701
Phone (580) 233-6100

600 S Monroe St
Enid, OK 73701
Phone (580) 233-2300

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1659346963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 W MEMORIAL RD",
            "address_2": "SUITE 140",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341785",
            "telephone_number": "405-752-3162",
            "fax_number": "405-936-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ACADEMY RD",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730448727",
            "telephone_number": "405-282-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "MARK",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "16492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231340A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "020654565002",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.