Provider Demographics
NPI:1356340939
Name:WORLEY, GREGORY A (DPM)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:WORLEY
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-0175
Mailing Address - Fax:859-746-7464
Practice Address - Street 1:351 CENTRE VIEW BLVD
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3477
Practice Address - Country:US
Practice Address - Phone:859-212-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00203213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000032861OtherANTHEM
OH0884404Medicaid
KY80002033Medicaid
KY90160599Medicaid
KY27-00337OtherUHC
KY4289745OtherAETNA
KY0111Medicare PIN
KY8423Medicare PIN
KY2011101Medicare PIN
KY2013802Medicare PIN
KYU32738Medicare UPIN
KY2011201Medicare PIN
KY000000032861OtherANTHEM
KYK122410Medicare PIN