NPIMap

Individual provider Active NPI

William Gregg, C.R.N.P.

  • Family Medicine Physician
  • Shawnee-on-Delaware, PA
National Provider Identifier
1831164102
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
VP005354B Issued in PA
Practice address
106 Shawnee Square Dr. Ste 101
Shawnee-on-Delaware, PA 18356
Phone
(570) 421-3900
Fax
(570) 424-1549
NPI assigned
Feb 21, 2006
Last updated
Nov 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X VP005354B PA Primary

Addresses

Primary practice location

106 Shawnee Square Dr. Ste 101
Shawnee-on-Delaware, PA 18356

Mailing address

P O Box 244
Buttermilk Falls Road
Shawnee-on-Delaware, PA 18356-0244
Phone (570) 421-3900

Other identifiers 2

IdentifierTypeStateIssuer
1007575050001MedicaidPA
744447OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000391 PA Practitioner - Nurse Practitioner 9032305503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

1581 N 9TH St
Stroudsburg, PA 18360-7576
Phone (272) 212-5122

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
VP005354BPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Family Medicine CurrentSince Jul 5, 2016 Accepting new patients
St. Luke's Physician Group, Inc. Family Medicine Current Accepting new patients
St Luke's Physician Group Inc Family Medicine CurrentSince Jul 5, 2016 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1581 N 9th St
Stroudsburg, PA 18360
Phone (272) 212-4490

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1831164102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 244",
            "address_2": "BUTTERMILK FALLS ROAD",
            "city": "SHAWNEE-ON-DELAWARE",
            "state": "PA",
            "postal_code": "183560244",
            "telephone_number": "570-421-3900",
            "fax_number": "570-424-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SHAWNEE SQUARE DR. STE 101",
            "city": "SHAWNEE-ON-DELAWARE",
            "state": "PA",
            "postal_code": "18356",
            "telephone_number": "570-421-3900",
            "fax_number": "570-424-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "VP005354B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007575050001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "744447",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee-on-Delaware, PA

Sources for this page

Verify at the official NPI Registry.