Individual provider Active NPI

Marion Anderson Gregg II, M.D., M.P.H, M.B.A

  • Public Health & General Preventive Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1801936836
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
0101237427 Issued in VA
Practice address
2080 Child St Dept 5000
Jacksonville, FL 32214-5000
Phone
(904) 524-9109
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 0101237427 VA Primary
General Practice Physician 208D00000X 0101237427 VA

Addresses

Primary practice location

2080 Child St Dept 5000
Jacksonville, FL 32214-5000

Mailing address

2080 Child St Dept 5000
Jacksonville, FL 32214-5000
Phone (904) 524-9109

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
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101237427VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1801936836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST DEPT 5000",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145000",
            "telephone_number": "904-524-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST DEPT 5000",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145000",
            "telephone_number": "904-524-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "MARION",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D., M.P.H, M.B.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "VA",
            "license": "0101237427",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101237427",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.