Individual provider Active NPI

Doris M Greenberg, MD

  • Developmental - Behavioral Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1194834218
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
18658 Issued in GA
Practice address
5120 Paulsen Street
Savannah, GA 31405
Phone
(912) 354-4953
Fax
(912) 352-1056
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 18658 GA Primary

Addresses

Primary practice location

5120 Paulsen Street
Savannah, GA 31405

Mailing address

5120 Paulsen Street
Savannah, GA 31405
Phone (912) 354-4953

Other identifiers 1

IdentifierTypeStateIssuer
00133515AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20080827000695 GA Practitioner - Pediatric Medicine 7214003268 Practice locations: Savannah, GA

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Albany Medical College of Union University, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5120 Paulsen St
Savannah, GA 31405-4618
Phone (912) 354-4953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18658GAMDDevelopmental - Behavioral Pediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1194834218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 PAULSEN STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-354-4953",
            "fax_number": "912-352-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 PAULSEN STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-354-4953",
            "fax_number": "912-352-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "DORIS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "GA",
            "license": "18658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00133515A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.