John Michael Greeley

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

022369 Issued in CT

Practice address

196 Parkway S
Suite 201B
Waterford, CT 06385-1234

Phone

(860) 439-0636

Fax

(860) 439-0711

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hartford Healthcare Medical Group, Inc

  dba Hartford HealthCare Medical Group

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301

  Family Medicine

  Medicare reassignment NPD
• Family Medicine Associates of Stamford, P.C.

  • Family Medicine Physician
  • Stamford, CT
  • NPI 1780791822
  NPD (past) Authorized official
• Advanced Spine and Pain Care, LLC

  • Physical Medicine & Rehabilitation Physician
  • Stamford, CT
  • NPI 1275704413
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1083621320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 201B",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-439-0636",
            "fax_number": "860-439-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 201B",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-439-0636",
            "fax_number": "860-439-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREELEY",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "022369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Golden, MD
• John M Gonzalez, PH.D.
• Mithlesh Govil, M.D.
• Rosemary Grace
• Thomas Grayeck, R.PH.
• Carol Ann Greene, COTA
• Linda Alexandra Greene, LCSW
• Greentree Manor Nursing and Rehabilitation Center Inc
• Jillian Grey, PT, DPT
• Kathleen McKenzie Griffith, LCSW

• Family Medicine Physician in Waterford, CT
• Providers in Waterford, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.