Mark J. Greenbaum, D.P.M., P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD000611 Issued in GA

Legal business name

MARK J. GREENBAUM, D.P.M., P.C.

Practice address

1835 Savoy Dr Ste 200
Atlanta, GA 30341-1073

Phone

(770) 279-2900

NPI assigned

Jul 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark J. Greenbaum, D.P.M.

Title

President/Physician

Phone

(770) 279-2900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mark J. Greenbaum, D.P.M., P.C.

  • Podiatrist
  • Blairsville, GA
  • NPI 1558555060

  7517955370

  Same PAC ID

Locations

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580428800000",
    "number": "1174713796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411073",
            "telephone_number": "770-279-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411073",
            "telephone_number": "770-279-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J. GREENBAUM, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "770-279-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00412068A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark a Codner MD LLC
• Mark C Hutto M.D. PC
• Mark E. Crispin, M.D., P.C.
• Mark G. Sayeg, DDS, PC
• Mark Gilson PHD PC
• Mark Lynn OD & Associates PC
• Mark Lynn OD & Associates PC
• Mark Vakkur, M.D., P.C.
• Amber Kristina Mark
• Aparna Mark, M.D.

• Podiatrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.