Individual provider Active NPI

Douglas M. Gregerson, D.C.

  • Radiology Chiropractor
  • Geneva, IL
National Provider Identifier
1659355139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
Practice address
0 S. 630 Preston CR
Geneva, IL 60134
Phone
(630) 845-0862
Fax
(630) 578-1018
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X IL Primary

Addresses

Primary practice location

0 S. 630 Preston CR
Geneva, IL 60134

Mailing address

0 S. 630 Preston CR
Geneva, IL 60134
Phone (630) 845-0862

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038005324ILMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
National University of Health Sciences PastSince Jun 1, 1997 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11209/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659355139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0 S. 630 PRESTON CR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-845-0862",
            "fax_number": "630-578-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0 S. 630 PRESTON CR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-845-0862",
            "fax_number": "630-578-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGERSON",
        "first_name": "DOUGLAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

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.

Verify at the official NPI Registry.