Individual provider Active NPI

Gregory R. Wollen, D.C.

  • Neurology Chiropractor
  • Orchard Park, NY
National Provider Identifier
1992824023
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
X009972-1 Issued in NY
Practice address
4407 S Buffalo St
Orchard Park, NY 14127-2611
Phone
(716) 662-7267
Fax
(716) 662-2781
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X X009972-1 NY Primary
Nutrition Chiropractor 111NN1001X X009972-1 NY

Addresses

Primary practice location

4407 S Buffalo St
Orchard Park, NY 14127-2611

Mailing address

4415 S Buffalo St
Orchard Park, NY 14127-2611
Phone (716) 662-7267

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

State licenses

LicenseStateTypeSpecialty
X009972-1NYMDNutrition Chiropractor
009972NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1992824023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 S BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272611",
            "telephone_number": "716-662-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 S BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272611",
            "telephone_number": "716-662-7267",
            "fax_number": "716-662-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLEN",
        "first_name": "GREGORY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NY",
            "license": "X009972-1",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "NY",
            "license": "X009972-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; 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.