DR. DAVID CARL GREGORY M.D. NPI 1871599522

Family Medicine in Peoria, IL

About DAVID GREGORY

David Gregory is a provider in Peoria, IL. The NPI number assigned to this provider is 1871599522. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 0 years ago.

NPI1871599522 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. DAVID CARL GREGORY M.D.
Provider Location Address1701 W GARDEN ST PEORIA, IL 61605 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address1701 W GARDEN ST PEORIA, IL 61605 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date06-27-2005 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-26-2017 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. DAVID CARL GREGORY M.D.
1701 W GARDEN ST
PEORIA, IL
ZIP 61605
Phone: (309) 680-7600
Fax: (309) 680-7686
Get Directions

Mailing Address

DR. DAVID CARL GREGORY M.D.
1701 W GARDEN ST
PEORIA, IL
ZIP 61605
Phone: (309) 680-7600
Fax: (309) 680-7686

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.036103155
License StateIL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
036103155MEDICAID (05)IL
H43870MEDICARE UPIN (02)IL

Map Location


DR. DAVID CARL GREGORY M.D. address is 1701 W GARDEN ST PEORIA, IL 61605

Other Providers at the same location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003814625 SARAH R KOSCICA MD
Individual
Family Medicine1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1053662783 EDWARD E ETHERTON NP
Individual
Nurse Practitioner1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1336193861HEARTLAND COMMUNITY HEALTH CLINIC
Organization
Clinic/Center (Federally Qualified Health Center (FQHC))1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1376925586 SHANNON DIANN PYLE NP-C
Individual
Nurse Practitioner (Family)1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1467546218 GREGG D STONER MD
Individual
Family Medicine1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1487054425 KATHRYN M ENDRESS NP
Individual
Nurse Practitioner (Family)1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1629092226 THEMBI A CONNER-GARCIA MD
Individual
Internal Medicine1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1710210711MS. AMY M. LIGHT LCPC
Individual
Counselor (Mental Health)1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1790889392 SANDRA K. LEMAN PA-C
Individual
Physician Assistant1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600
1902951957 TINA R SADDLER APN
Individual
Nurse Practitioner (Family)1701 W GARDEN ST
PEORIA, IL 61605
(309) 680-7600