GREGORY JACKSON AYCOCK CAA NPI 1215924527

NPI Information

NPI: 1215924527
Provider Name: GREGORY JACKSON AYCOCK, CAA
Classification: Anesthesiologist Assistant - 367H00000X
Entity Type: Individual
Address: 615 S NEW BALLAS RD DEPT OF
SAINT LOUIS, MO
ZIP 63141
Phone: (636) 386-9224

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NPI Details

Gregory Jackson Aycock, CAA is an anesthesiologist assistant in Saint Louis, MO with 2 years of experience. The provider is an individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. Gregory Jackson Aycock, CAA NPI is 1215924527. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

615 S NEW BALLAS RD DEPT OF
SAINT LOUIS, MO
ZIP 63141-221
Phone: (636) 386-9224

The enumeration date for this NPI number is 10/3/2005 and was last updated on 11/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	183500000X	Pharmacist	PS40328	FLORIDA	No
2	183500000X	Pharmacist	17641	NORTH CAROLINA	No
3	367H00000X	Anesthesiologist Assistant	75000176A	INDIANA	No
4	367H00000X	Anesthesiologist Assistant	PENDING	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1103727700	OTHER	INDIANA	ANTHEM PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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