Charles Henry Greene III, MS, PT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1068862 Issued in MO

Practice address

203 S Polk St
Albany, MO 64402-1618

Phone

(660) 726-5762

Fax

(660) 726-5764

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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.

• Grand River Physical Therapy & Sports Medicine, Inc

  • Athletic Trainer
  • Albany, MO
  • NPI 1841231214

  Physical Therapist

  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073554986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S POLK ST",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644021618",
            "telephone_number": "660-726-5762",
            "fax_number": "660-726-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S POLK ST",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644021618",
            "telephone_number": "660-726-5762",
            "fax_number": "660-726-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MS, PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "104902",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1101879",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MO",
            "license": "104902",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "1068862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "25783024",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gentry County Association for Retarded Citizens, Inc.
• Gentry County Association for Retarded Citizens, Inc.
• Gentry County Association for Retarded Citizens, Inc.
• Gentry County Associaton for Retarded Citizens, Inc.
• Grand River Physical Therapy & Sports Medicine, Inc
• Morris Michael Gregory, H.I.S.
• Denice R Harness
• Heart and Hand Care Services
• Brooke Janay Hornberger, PA-C
• Howell Place LLC

• All providers in Albany, MO
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.