Individual provider Active NPI

Thomas E Greenwood, M.D.

  • Family Medicine Physician
  • Winslow, AZ
National Provider Identifier
1205805090
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30533 Issued in AZ
Practice address
200 East Lee Street
Winslow, AZ 86047
Phone
(928) 289-3396
Fax
(928) 289-2801
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30533 AZ Primary

Addresses

Primary practice location

200 East Lee Street
Winslow, AZ 86047

Mailing address

200 East Lee Street
Winslow, AZ 86047
Phone (928) 289-3396

Other identifiers 1

IdentifierTypeStateIssuer
708894MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040121000222 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 4789586801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winslow Memorial Hospital IncGroup PAC ID 8628988409, 44 clinicians

Practice addresses (Care Compare)

1501 N Williamson Ave
Winslow, AZ 86047-2735
Phone (928) 289-4691

200 Lee St
Winslow, AZ 86047-2603
Phone (928) 289-3396

Hospital & facility affiliations

  • Angels Care Home Health of Arizona No 5 Home health agency, Flagstaff, AZ, CCN 037500
  • Little Colorado Medical Center Hospital, Winslow, AZ, CCN 031311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30533AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Memorial Hospital Inc CurrentSince Jan 1, 2001 Accepting new patients
Winslow Memorial Hospital Inc CurrentSince Aug 5, 2002 Accepting new patients
Emcare Physician Providers, Inc Past Accepting new patients
Hospital Inpatient Services of Winslow LLC Past Accepting new patients

Locations

200 Lee St
Winslow, AZ 86047
Phone (928) 226-6400

1500 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-3396

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Little Colorado Medical CenterWinslow, AZ, CCN 03Z311 Hospital W-2 Managing Employee Jan 1, 2001
Little Colorado Medical CenterWinslow, AZ, CCN 031311 Hospital Other Apr 1, 2022
Little Colorado Physicians OfficeWinslow, AZ, CCN 038507 Rural health clinic W-2 Managing Employee Jan 1, 2001

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1205805090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EAST LEE STREET",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "86047",
            "telephone_number": "928-289-3396",
            "fax_number": "928-289-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAST LEE STREET",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "86047",
            "telephone_number": "928-289-3396",
            "fax_number": "928-289-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWOOD",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "30533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "708894",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.