Active NPI
Gregory Lee Ivy, RN
- Hemodialysis Registered Nurse
- Eugene, OR
National Provider Identifier
1790914711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hemodialysis Registered Nurse
- License
- 080044735RN
- Practice address
- 615 Kourt Dr
Eugene, OR 97404-2279 - Phone
- (541) 514-4891
- Fax
- (866) 669-7086
- NPI assigned
- Jul 12, 2009
- 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 |
|---|---|---|---|---|
| Hemodialysis Registered Nurse | 163WH0500X | 080044735RN | OR | Primary |
Addresses
Primary practice location
615 Kourt Dr
Eugene, OR 97404-2279
Mailing address
615 Kourt Dr
Eugene, OR 97404-2279
Phone (541) 514-4891
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 080044735RN | OR | MD | Hemodialysis Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247356800000",
"number": "1790914711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 KOURT DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974042279",
"telephone_number": "541-514-4891",
"fax_number": "866-669-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 KOURT DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974042279",
"telephone_number": "541-514-4891",
"fax_number": "866-669-7086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVY",
"first_name": "GREGORY",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-12",
"last_updated": "2009-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hemodialysis",
"state": "OR",
"license": "080044735RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.