Greenbrae Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GREENBRAE SURGERY CENTER

Practice address

575 Sir Francis Drake Blvd
Suite 3
Greenbrae, CA 94904-2306

Phone

(415) 925-8900

Fax

(415) 925-8908

NPI assigned

Oct 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Shannon Marie Smith

Title

Interim Administrator

Phone

(415) 885-4900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144316001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 3",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042306",
            "telephone_number": "415-925-8900",
            "fax_number": "415-925-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE 3",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042306",
            "telephone_number": "415-925-8900",
            "fax_number": "415-925-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRAE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "INTERIM ADMINISTRATOR",
        "authorized_official_telephone_number": "415-885-4900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Jayme Graham, RN, MSN, NP-C
• Tofani Grava, LMFT
• Andrea Gray, M.D.
• Greenbrae Care Center, LLC (Kindred Transitional Care and Rehabilitation-South Marin)
• Greenbrae Dermatology, a Medical Corporation
• Greenbrae Surgery Center
• Greenbrae Surgery Center LLC
• Ron Greene, PH.D
• Lisa-Sun Gresham
• Gery Charles Grey, DDS

• Ambulatory Surgical Clinic/Center in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.