Individual provider Active NPI

Susan Mobley Greene, M.D.

  • Obstetrics & Gynecology Physician
  • Savannah, GA
National Provider Identifier
1063718187
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
074041 Issued in GA
Practice address
101 W Mulberry Blvd Ste 100
Savannah, GA 31407-3507
Phone
(912) 350-5937
Fax
(912) 350-3483
NPI assigned
Feb 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 074041 GA Primary

Addresses

Primary practice location

101 W Mulberry Blvd Ste 100
Savannah, GA 31407-3507

Mailing address

101 W Mulberry Blvd Ste 100
Savannah, GA 31407-3507
Phone (912) 350-5937

Other identifiers 1

IdentifierTypeStateIssuer
003162507AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150730011709 GA Practitioner - Obstetrics/Gynecology 9335453604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Mercer University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

101 W Mulberry Blvd
Suite 100
Savannah, GA 31407-3507
Phone (912) 352-8700

1101 Lexington Ave
Savannah, GA 31404-5502
Phone (912) 350-7020

4700 Waters Ave
Savannah, GA 31404-6220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Multispecialty Associates, LLC Obstetrics & Gynecology CurrentSince Feb 1, 2018 Accepting new patients
Savannah Health Services, LLC Past Accepting new patients

Locations

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

101 W Mulberry Blvd
Ste 100
Savannah, GA 31407
Phone (912) 350-6000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1063718187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MULBERRY BLVD STE 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314073507",
            "telephone_number": "912-350-5937",
            "fax_number": "912-350-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MULBERRY BLVD STE 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314073507",
            "telephone_number": "912-350-5937",
            "fax_number": "912-350-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "SUSAN",
        "middle_name": "MOBLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "074041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003162507A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.