Individual provider Active NPI

Jennifer Fern Gregory, M.D.

  • Dermatology Physician
  • South Boston, VA
National Provider Identifier
1902146707
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101256718 Issued in VA
Practice address
3459 Old Halifax Rd Ste I
South Boston, VA 24592-4900
Phone
(434) 549-0383
Fax
(434) 549-0384
NPI assigned
Feb 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101256718 VA Primary

Addresses

Primary practice location

3459 Old Halifax Rd Ste I
South Boston, VA 24592-4900

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jennifer.Gregory@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210325000047 VA Practitioner - Dermatology 7315354016 Reassigns benefits to 2 organizations
I20210325001158 DC Practitioner - Dermatology 7315354016

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

3459 Old Halifax Rd
Suite I
South Boston, VA 24592-4900
Phone (434) 549-0383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision64
Removal of skin lesions2813
Removal of nail tissue1-10
Removal or shaving of skin growth30
Skin biopsy605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Sep 1, 2022 Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Sep 1, 2022 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

5201 Hickory Park Dr
Ste A
Glen Allen, VA 23059
Phone (804) 262-6060

3459 Old Halifax Rd
Ste I
South Boston, VA 24592
Phone (434) 549-0383

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: jennifer.gregory@forefrontdermatology.emadirect.md

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 1

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": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1902146707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 OLD HALIFAX RD STE I",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245924900",
            "telephone_number": "434-549-0383",
            "fax_number": "434-549-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JENNIFER",
        "middle_name": "FERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101256718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jennifer.Gregory@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "3459 Old Halifax Rd Ste I",
            "city": "South Boston",
            "state": "VA",
            "country_code": "US",
            "postal_code": "245924900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.