Active NPI
Gregory Boren, MD
- Anatomic Pathology & Clinical Pathology Physician
- Cincinnati, OH
National Provider Identifier
1770558322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 35031085
- Practice address
- 3131 Queen City Ave
Cincinnati, OH 45238-2316 - Phone
- (513) 389-5268
- NPI assigned
- Feb 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 35031085 | OH | Primary |
Addresses
Primary practice location
3131 Queen City Ave
Cincinnati, OH 45238-2316
Mailing address
5620 Southwyck Blvd
Toledo, OH 43614-1501
Phone (419) 866-1804
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0532123 | Medicaid | OH |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35031085 | OH | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1770558322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5620 SOUTHWYCK BLVD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436141501",
"telephone_number": "419-866-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 QUEEN CITY AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452382316",
"telephone_number": "513-389-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOREN",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OH",
"license": "35031085",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0532123",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.