Individual provider Active NPI

Stephanie Shireen Gregory, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Marietta, GA
National Provider Identifier
1912341975
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
81982 Issued in GA
Practice address
3747 Roswell Rd Ste 201
Marietta, GA 30062-6227
Phone
(470) 956-1590
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Epilepsy Physician 2084E0001X 81982 GA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 81982 GA Primary

Addresses

Primary practice location

3747 Roswell Rd Ste 201
Marietta, GA 30062-6227

Mailing address

3747 Roswell Rd Ste 201
Marietta, GA 30062-6227
Phone (470) 956-1590

Other practice location 1

622 W 168th St
New York, NY 10032-3720
Phone (212) 305-5437

Other practice location 2

1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-4000

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
81982GAMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

3747 Roswell Rd
Ste 201
Marietta, GA 30062
Phone (470) 956-1590

Interoperability endpoints

  • Direct secure messaging: sgregory439248@directwellstar.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1912341975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 ROSWELL RD STE 201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626227",
            "telephone_number": "470-956-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 ROSWELL RD STE 201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626227",
            "telephone_number": "470-956-1590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "622 W 168th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323720",
            "country_code": "US",
            "telephone_number": "212-305-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "STEPHANIE",
        "middle_name": "SHIREEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "GA",
            "license": "81982",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "81982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.