Active NPI
Gregory Allen Carl, MD
- Otolaryngology Physician
- Pasco, WA
National Provider Identifier
1891807053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MD00022219
- Practice address
- 1200 N 14TH Ave
Ste 220
Pasco, WA 99301 - Phone
- (509) 545-4800
- Fax
- (509) 545-4861
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD00022219 | WA | Primary |
Addresses
Primary practice location
1200 N 14TH Ave
Ste 220
Pasco, WA 99301
Mailing address
1200 N 14TH Ave
Ste 220
Pasco, WA 99301
Phone (509) 545-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000660 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00022219 | WA | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of Lourdes Health Center Dba Lourdes Ear Nose and Throat Asso | Otolaryngology | Past | Accepting new patients |
| Lourdes Hospital LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Otolaryngology Physician
- Pasco, WA
- NPI 1083928709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891807053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N 14TH AVE",
"address_2": "STE 220",
"city": "PASCO",
"state": "WA",
"postal_code": "99301",
"telephone_number": "509-545-4800",
"fax_number": "509-545-4861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N 14TH AVE",
"address_2": "STE 220",
"city": "PASCO",
"state": "WA",
"postal_code": "99301",
"telephone_number": "509-545-4800",
"fax_number": "509-545-4861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARL",
"first_name": "GREGORY",
"middle_name": "ALLEN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "WA",
"license": "MD00022219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000660",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasco, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.