NPIMap

Organization Active NPI

Gary Gregerson MD PA

Doing business as Advanced Specialty Care for Women

  • Obstetrics & Gynecology Physician
  • Nampa, ID
National Provider Identifier
1902179914
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-6312 Issued in ID
Legal business name
GARY GREGERSON MD PA
Doing business as
Advanced Specialty Care for Women
Practice address
1611 12TH Ave Road
Suite a
Nampa, ID 83686-6182
Phone
(208) 468-9400
Fax
(208) 468-9447
NPI assigned
Feb 22, 2012
Last updated
Jan 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Gary N Gregerson, MDNPI 1801834866
Title
Sole Owner
Phone
(208) 468-9400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M-6312 ID Primary

Addresses

Primary practice location

1611 12TH Ave Road
Suite a
Nampa, ID 83686-6182

Mailing address

1611 12TH Ave Road
Suite a
Nampa, ID 83686-6182
Phone (208) 468-9400

Other names 1

  • Advanced Specialty Care for Women Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1902179914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 12TH AVE ROAD",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866182",
            "telephone_number": "208-468-9400",
            "fax_number": "208-468-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 12TH AVE ROAD",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866182",
            "telephone_number": "208-468-9400",
            "fax_number": "208-468-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY GREGERSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "GREGERSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "208-468-9400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-6312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Specialty Care for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.