Provider Demographics
NPI:1407872062
Name:NEIMEYER, GREGORY JAMES (PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JAMES
Last Name:NEIMEYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:GREGORY
Other - Middle Name:JAMES
Other - Last Name:NEIMEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2301 1ST AVE N APT 301
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-4320
Mailing Address - Country:US
Mailing Address - Phone:026-747-8002
Mailing Address - Fax:
Practice Address - Street 1:2301 1ST AVE N APT 301
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-4320
Practice Address - Country:US
Practice Address - Phone:026-747-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3746103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377007900Medicaid
FL75996YMedicare PIN
FL75996Medicare ID - Type Unspecified