Dr. Gregg Sydow
Radiology (Diagnostic Radiology)

Address: 4062 S Holland Rd, Flagstaff, AZ 86005-8967
Phone: 9525951100

Dr. Gregg Sydow (NPI# 1619157609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1619157609
Entity Type Individual
Full Name Dr. Gregg Sydow
Credential M.D.
Gender Male
Practice Address 4062 S Holland Rd
Flagstaff
AZ 86005-8967
Practice Telephone 9525951100
Practice Fax Number 6122944903
Mailing Address 11995 Singletree Ln Ste 500
Eden Prairie
MN 55344-5349
Mailing Telephone 9525951301
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2007-11-07
Last Update Date 2016-01-13

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 2085R0202X Radiology · Diagnostic Radiology Allopathic & Osteopathic Physicians 47172 AZ

Physician Overview

NPI 1619157609
PAC ID by PECOS 6002057296
Professional Enrollment ID I20130731000343
Full Name Gregg P Sydow
Organization Legal Name VIRTUAL RADIOLOGIC PROFESSIONALS LLC
Phone Number 9525951100
Gender M
Medical School SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2007
Primary Specialty DIAGNOSTIC RADIOLOGY
Group Practice PAC ID 4981608817
Number of Group Practice Members 292
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
030002 BANNER - UNIVERSITY MEDICAL CENTER PHOENIX
330028 RICHMOND UNIVERSITY MEDICAL CENTER
260040 COX MEDICAL CENTERS
330221 WYCKOFF HEIGHTS MEDICAL CENTER
220012 CAPE COD HEALTHCARE

Office Location

Street Address 4062 S HOLLAND RD
City FLAGSTAFF
State AZ
Zip Code 86005-8967

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760997126 Whitney James, Md, PC Neurological Surgery 432 W Cattle Drive Trl, Flagstaff, AZ 86005 2017-12-07
1851776785 Libby Smith Counselor 3240 S. Trotter Lane, Flagstaff, AZ 86005 2015-07-21
1255484580 Melanie Glass Watters Physical Therapist 2342 Mongwa Ovi, Flagstaff, AZ 86005-3531 2007-01-19
1568871366 J Wynne Geikenjoyner Physical Therapist 4247 Canyon Loop, Flagstaff, AZ 86005-3726 2014-08-05
1174592380 Carol L. O'saben Psychologist 4289 Canyon Loop, Flagstaff, AZ 86005-3726 2006-03-17
1275005068 Jennifer Leigh Cody Respite Care 2583 Chof Trl, Flagstaff, AZ 86005-3737 2018-12-18
1528260155 Laura Ann Kinghan Occupational Therapist 3623 Kachina Trail, #8, Flagstaff, AZ 86005-3786 2007-06-05
1114386570 Laurenlee Rae Occupational Therapist 2580 Nakai Trl, Flagstaff, AZ 86005-3796 2016-02-15
1093218877 Vanessa Margaret Scheu Nurse Practitioner 3861 Jemez, Flagstaff, AZ 86005-4061 2018-03-17
1689110447 Savannah P Ross Speech-Language Pathologist 3818 S Walapai Dr Apt 2, Flagstaff, AZ 86005-6672 2017-01-17
Find all providers in zip 86005

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477508935 Jennifer J. Kottra Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1831148147 James T. Friedland Radiology 7600 Pine Canyon Dr, Flagstaff, AZ 86004-1266 2006-05-06
1386699643 Michael J. Labenz Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-24
1497700579 Stephen V. Ward Radiology 77 W Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-24
1134174618 Paul Hiette Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1114972593 Paul E Sangster Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1578518957 Edward P. Herman Radiology 77 W Forest Ave, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1285689661 Leslie N. Nishimi Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1902851389 Kenneth V Salce Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
1710932199 James A Skrocki Radiology 77 W. Forest Avenue, Suite 101, Flagstaff, AZ 86001-1482 2006-05-23
Find all providers in FLAGSTAFF

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City FLAGSTAFF
Zip Code 86005

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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