Provider Demographics
NPI:1225123730
Name:MARTHA GREGORY & ASSOC., INC.
Entity Type:Organization
Organization Name:MARTHA GREGORY & ASSOC., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENEZIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-458-4238
Mailing Address - Street 1:3010 TAYLOR SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220
Mailing Address - Country:US
Mailing Address - Phone:502-458-4588
Mailing Address - Fax:502-458-4240
Practice Address - Street 1:3010 TAYLOR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220
Practice Address - Country:US
Practice Address - Phone:502-458-4588
Practice Address - Fax:502-458-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7042Medicare ID - Type Unspecified