Healthcare Provider Details

I. General information

NPI: 1215047352
Provider Name (Legal Business Name): GARY GREGASAVITCH, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 HERITAGE VILLAGE PLZ STE 230
GAINESVILLE VA
20155-3095
US

IV. Provider business mailing address

14932 SIMMONS GROVE DR
HAYMARKET VA
20169-2300
US

V. Phone/Fax

Practice location:
  • Phone: 703-273-9332
  • Fax: 888-246-3989
Mailing address:
  • Phone: 703-887-0735
  • Fax: 888-246-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number0103300881
License Number StateVA

VIII. Authorized Official

Name: DR. GARY F GREGASAVITCH
Title or Position: PRESIDENT/OWNER
Credential: DPM
Phone: 703-858-3211