Individual
GREGORY G ENNIS
Active
Individual
GREGORY G ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01051903A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000078150
BCBS PIN
IN
01
—
064756
HAMP PIN
IN
01
—
145885
UMWA PIN
IN
01
—
1761906
FIRST HEALTH PIN
IN
01
—
423127
HEALTHLINK NONPAR PIN
IN
01
—
610186900
FECA PIN
IN
05
—
64003460
—
KY
Enumeration date
09/22/2006
Last updated
04/20/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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