Active NPI
Gregory Paul Hollis, PH.D.
- Clinical Neuropsychologist
- Saint Louis, MO
National Provider Identifier
1982855276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY001417
- Practice address
- 12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393 - Phone
- (800) 325-3982
- NPI assigned
- Oct 5, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY001417 | GA | Primary |
Addresses
Primary practice location
12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393
Mailing address
3 Myrtle Bank Rd
Hilton Head Island, SC 29926-1809
Phone (843) 290-0253
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY001417 | GA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223164800000",
"number": "1982855276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MYRTLE BANK RD",
"city": "HILTON HEAD ISLAND",
"state": "SC",
"postal_code": "299261809",
"telephone_number": "843-290-0253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12647 OLIVE BLVD",
"address_2": "SUITE 600",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416393",
"telephone_number": "800-325-3982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIS",
"first_name": "GREGORY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-05",
"last_updated": "2008-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "GA",
"license": "PSY001417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.