David Carl Gregory, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036103155 Issued in IL

Practice address

2321 N Wisconsin Ave
Peoria, IL 61603-5613

Phone

(309) 495-8644

Fax

(309) 681-8443

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Heartland Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Peoria, IL
  • NPI 1336193861
  Medicare reassignment NPD
• Heartland Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Peoria, IL
  • NPI 1922561000
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Heartland Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Peoria, IL
  • NPI 1467658443
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1871599522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-495-8644",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 N WISCONSIN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616035613",
            "telephone_number": "309-495-8644",
            "fax_number": "309-681-8443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 W Garden St",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616053531",
            "country_code": "US",
            "telephone_number": "309-680-7600",
            "fax_number": "309-680-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "DAVID",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103155",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Greene
• Jennifer Greenwood
• Tracey J Greenwood, M.S.-SLP/L
• Elizabeth Greer
• Shelley Falkin Gregg
• Heather Marie Greiner
• Craig Griebel, MD
• Nicholas Grieco
• Rachel Suzanne Grieder, DPM
• Amanda Lizette Griffin, MD

• Family Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.