Individual provider Active NPI

Gregory B Pollock

  • Family Nurse Practitioner
  • New Port Richey, FL
National Provider Identifier
1699434605
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016708 Issued in FL
Practice address
6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone
(855) 232-0644
Fax
(888) 546-0488
NPI assigned
Dec 17, 2021
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11016708 FL
Family Nurse Practitioner 363LF0000X APRN11016708 FL Primary

Addresses

Primary practice location

6804 Cecelia Drive
New Port Richey, FL 34653-4935

Mailing address

6804 Cecelia Drive
New Port Richey, FL 34653-4935
Phone (855) 232-0644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318000415 FL Practitioner - Nurse Practitioner 6204221849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11016708FLMDNurse Practitioner
APRN11016708FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Florida P.a. CurrentSince Jun 6, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

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.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1699434605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 CECELIA DRIVE",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346534935",
            "telephone_number": "855-232-0644",
            "fax_number": "888-546-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "GREGORY",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11016708",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.