Organization Active NPI

Estate Ventures, LLC

Doing business as McGreevy Neurohealth

  • Pain Medicine Physician
  • St Augustine, FL
National Provider Identifier
1033505706
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME109028 Issued in FL
Legal business name
ESTATE VENTURES, LLC
Doing business as
McGreevy Neurohealth
Practice address
559 W Twincourt TRL
#607
St Augustine, FL 32095-8805
Phone
(904) 230-3006
NPI assigned
Apr 9, 2015
Last updated
Aug 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kai McGreevy, MDNPI 1922208610
Title
Owner
Phone
(904) 230-3006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME109028 FL
Pain Medicine Physician 208VP0000X ME109028 FL Primary

Addresses

Primary practice location

559 W Twincourt TRL
#607
St Augustine, FL 32095-8805

Mailing address

559 W Twincourt TRL
#607
St Augustine, FL 32095-8805
Phone (904) 230-3006

Other names 1

  • McGreevy Neurohealth Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150902001390 FL Part B Supplier - Clinic/Group Practice 6103132352 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Coast, FL

National Provider Directory

National Provider Directory

Locations

559 W Twincourt Trl
Unit 607608
Saint Augustine, FL 32095

559 W Twincourt Trl
Unit 607
St Augustine, FL 32095
Phone (904) 230-3006

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1033505706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL",
            "address_2": "#607",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "904-230-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 W TWINCOURT TRL",
            "address_2": "#607",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958805",
            "telephone_number": "904-230-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTATE VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "MCGREEVY",
        "authorized_official_first_name": "KAI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-230-3006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME109028",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME109028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McGreevy Neurohealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.