Active NPI
Gregg K. Omura, MD
- Family Medicine Physician
- Grand Junction, CO
National Provider Identifier
1992788582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22815
- Practice address
- 1120 Wellington Avenue
Grand Junction, CO 81501-5517 - Phone
- (970) 241-6011
- Fax
- (970) 241-4650
- NPI assigned
- Nov 28, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22815 | CO | Primary |
Addresses
Primary practice location
1120 Wellington Avenue
Grand Junction, CO 81501-5517
Mailing address
1120 Wellington Avenue
PO Box 10700
Grand Junction, CO 81502-5517
Phone (970) 241-6011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01228154 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22815 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1992788582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 WELLINGTON AVENUE",
"address_2": "PO BOX 10700",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815025517",
"telephone_number": "970-241-6011",
"fax_number": "970-241-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 WELLINGTON AVENUE",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815015517",
"telephone_number": "970-241-6011",
"fax_number": "970-241-4650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMURA",
"first_name": "GREGG",
"middle_name": "K.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-28",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "22815",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01228154",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
- Marcia Ann Olson, M.S., CCC A
- Olsson Physical Therapy Inc
- Ulrik John Olsson, PT MTC
- Lukas Richard Ommen, MD
- Omnicare of New York, LLC (Omnicare of Grand Junction)
- Kathleen Sanae Ono, D.O.
- Lisa Ann Onorato, LSW
- Marla Oppenheim, ED.S.
- Optimal Performance Physical Therapy and Coaching
- Oral Health Partners, Professional LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.