Gregory Marc Todd

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306604863 Issued in VA

Practice address

576 Jefferson Ave
Fort Eustis, VA 23604-5548

Phone

(757) 314-7617

NPI assigned

Sep 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1881366607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045548",
            "telephone_number": "757-314-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045548",
            "telephone_number": "757-314-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "GREGORY",
        "middle_name": "MARC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnathan Matthew Taylor, DNP, APRN, NP-C, CEN
• Letitia Ann Taylor
• Kathryn Christina Thomas
• James Leon Thompson, D.M.D.
• Demitris Marlena Tillman, PTA
• Clifton Trinidad, PA-C
• Johnna Jolene Turner, RD, LD
• Bernadette Udeozor, NP
• Usameddac Ft Eustis VA
• Usv Optical Inc

• Physical Therapy Assistant in Fort Eustis, VA
• Providers in Fort Eustis, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.