Individual provider Active NPI

John B Gregory, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lebanon, NH
National Provider Identifier
1952312183
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0305 Issued in NH
Practice address
127 Mascoma St
Lebanon, NH 03766-2661
Phone
(603) 443-9572
Fax
(603) 443-9521
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0305 NH
Foot & Ankle Surgery Podiatrist 213ES0103X 0305 NH Primary

Addresses

Primary practice location

127 Mascoma St
Lebanon, NH 03766-2661

Mailing address

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 443-9572

Other identifiers 5

IdentifierTypeStateIssuer
1011596MedicaidVT
U71898OtherHARVARD PILGRIM
03Y007385NH02OtherNHANTHEM BCBS
00068170OtherVTBLUE CROSS BLUE SHIELD
30363594MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914000993 NH Practitioner - Podiatry 9537136056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0305NHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital Podiatrist CurrentSince Apr 6, 2015 Accepting new patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Apr 8, 2019 Accepting new patients
Active Ankle & Foot Center PLLC Podiatrist PastSince Apr 19, 2005 Accepting new patients

Locations

20 W Park St
Ste 3A
Lebanon, NH 03766
Phone (603) 448-3668

20 W Park St
Ste 320
Lebanon, NH 03766
Phone (603) 448-3668

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

127 Mascoma St
Lebanon, NH 03766
Phone (603) 443-9572

Interoperability endpoints

  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: jgregory353888@direct.dartmouth-hitchcock.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1952312183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662900",
            "telephone_number": "603-443-9572",
            "fax_number": "603-443-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MASCOMA ST",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662661",
            "telephone_number": "603-443-9572",
            "fax_number": "603-443-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "0305",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NH",
            "license": "0305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011596",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "U71898",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "03Y007385NH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00068170",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30363594",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.