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NPI Code Detail

MEDICARE: MR. RICHARD GREGORY PA-C

MEDICARE: MR. RICHARD GREGORY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant103021NC
2363AM0700XMedical Physician Assistant103021NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1136YAOTHERNCBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093856536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD GREGORY PA-C
Provider Business Mailing Address
First Line : 111 HOSPITAL DR
Second Line :
City : TARBORO
State : NC
Zip : 27886-2011
Country : US
Telephone Number : 252-641-7150
Fax Number :
Provider Business Practice Location Address
First Line : 2100 STANTONSBURG RD
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-2818
Country : US
Telephone Number : 252-641-7150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 12/02/2025

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