NPIMap

Individual provider Active NPI

Johnasan M Gregory, M.D.

  • Gastroenterology Physician
  • Sherman, TX
National Provider Identifier
1699774869
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G8150 Issued in TX
Practice address
300 N Highland Ave Ste 340
Sherman, TX 75092-7392
Phone
(903) 957-0233
Fax
(903) 957-0263
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G8150 TX
Gastroenterology Physician 207RG0100X G8150 TX Primary

Addresses

Primary practice location

300 N Highland Ave Ste 340
Sherman, TX 75092-7392

Mailing address

300 N Highland Ave Ste 340
Sherman, TX 75092-7392
Phone (903) 957-0233

Other identifiers 2

IdentifierTypeStateIssuer
126499603MedicaidTX
G8150OtherTXLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060202000660 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 5698742922
I20240105003185 AR Practitioner - Internal Medicine 5698742922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 Ada Ave
Suite 201
Conway, AR 72034-4984
Phone (501) 852-1360

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy41
Upper gastrointestinal (GI) endoscopy for acid reflux69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G8150TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Conway Regional Medical Center, Inc Gastroenterology CurrentSince Jan 1, 2024 Accepting new patients
Conway Regional Medical Center, Inc. Current Accepting new patients

Locations

2200 Ada Ave
Ste 201
Conway, AR 72034
Phone (501) 852-1360

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1699774869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N HIGHLAND AVE STE 340",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750927392",
            "telephone_number": "903-957-0233",
            "fax_number": "903-957-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N HIGHLAND AVE STE 340",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750927392",
            "telephone_number": "903-957-0233",
            "fax_number": "903-957-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JOHNASAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G8150",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G8150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126499603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G8150",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.