NPIMap

Individual provider Active NPI

Gregory A Fleck, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1942677950
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71005728A Issued in IN
Practice address
901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521
Phone
(812) 473-2642
NPI assigned
Aug 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209018496 IL
Acute Care Nurse Practitioner 363LA2100X 71005728A IN Primary

Addresses

Primary practice location

901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521

Mailing address

901 Saint Marys Dr Ste 300
Evansville, IN 47714-0521

Other identifiers 1

IdentifierTypeStateIssuer
201319220MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gregory.fleck.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151001002144 IN Practitioner - Nurse Practitioner 0244548782 Reassigns benefits to 1 organization
I20190218000407 IL Practitioner - Nurse Practitioner 0244548782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

901 Saint Marys Dr
Suite 300
Evansville, IN 47714-0521
Phone (812) 473-2642

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
  • Ascension St Vincent Warrick Hospital, Boonville, IN, CCN 151325
  • Hamilton Memorial Hospital Hospital, McLeansboro, IL, CCN 141326
  • Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324
  • Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209018496ILMDAcute Care Nurse Practitioner
71005728AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Physicians Network LLC Current Accepting new patients
St Mary'S Medical Group, LLC Acute Care CurrentSince Oct 1, 2015 Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Oct 1, 2015 Accepting new patients

Locations

1112 Oak St
Carmi, IL 62821
Phone (217) 732-9651

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

901 Saint Marys Dr
Ste 300
Evansville, IN 47714
Phone (812) 485-7725

1400 Professional Blvd
Ste 210
Evansville, IN 47714

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

Organizations & group practices 3

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.

Hospital & facility affiliations 12

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1942677950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 300",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAINT MARYS DR STE 300",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140521",
            "telephone_number": "812-473-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLECK",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209018496",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71005728A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201319220",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregory.fleck.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "901 Saint Marys Dr Ste 300",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.