David Scott Greenaway, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8690 Issued in FL

Practice address

62 Lenox Pointe NE
Suite B
Atlanta, GA 30324-7409

Phone

(904) 330-8204

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Bluestem Center for Child and Family Development, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester, MN
  • NPI 1003868167
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1124076237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "UNIT 6",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827215",
            "telephone_number": "904-473-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 LENOX POINTE NE",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303247409",
            "telephone_number": "904-330-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAWAY",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8690",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "555802958A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Theresa Green, RN
• Tiarra Green
• Timothy Green Jr.
• Victoria Green
• Victoria La Shelle Green, MD
• Adam B. Greenbaum, M.D.
• Addison Paige Greenbaum
• Laurence Greenbaum, MD, PHD
• Mark J. Greenbaum, D.P.M.
• Victoria Greenbaum

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.