Active NPI
Gregory Michael Gomori, D.O.
- Internal Medicine Physician
- Austintown, OH
National Provider Identifier
1710375894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 34.004597
- Practice address
- 5841 Boulder Creek Dr
Austintown, OH 44515-4267 - Phone
- (330) 792-0898
- Fax
- (330) 792-0898
- NPI assigned
- Dec 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 34.004597 | OH | Primary |
Addresses
Primary practice location
5841 Boulder Creek Dr
Austintown, OH 44515-4267
Mailing address
5841 Boulder Creek Dr
Austintown, OH 44515-4267
Phone (330) 792-0898
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.004597 | OH | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419379200000",
"number": "1710375894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 BOULDER CREEK DR",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154267",
"telephone_number": "330-792-0898",
"fax_number": "330-792-0898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 BOULDER CREEK DR",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "445154267",
"telephone_number": "330-792-0898",
"fax_number": "330-792-0898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMORI",
"first_name": "GREGORY",
"middle_name": "MICHAEL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-24",
"last_updated": "2014-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "34.004597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austintown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.