Individual provider Active NPI

Victor L Greener, D.P.M.

  • Podiatrist
  • Madera, CA
National Provider Identifier
1205947181
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3225 Issued in CA
Practice address
300 E Almond Ave Ste 105
Madera, CA 93637-5653
Phone
(559) 674-3338
Fax
(559) 674-1149
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3225 CA Primary

Addresses

Primary practice location

300 E Almond Ave Ste 105
Madera, CA 93637-5653

Mailing address

300 E Almond Ave Ste 105
Madera, CA 93637-5653
Phone (559) 674-3338

Other identifiers 1

IdentifierTypeStateIssuer
000E32250MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3225CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1205947181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E ALMOND AVE STE 105",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375653",
            "telephone_number": "559-674-3338",
            "fax_number": "559-674-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E ALMOND AVE STE 105",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375653",
            "telephone_number": "559-674-3338",
            "fax_number": "559-674-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENER",
        "first_name": "VICTOR",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E32250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.