Individual provider Active NPI

Justin Matthew Greenfield

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1215374426
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN195971 Issued in GA
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-1436
Fax
(843) 402-1833
NPI assigned
May 29, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN195971 GA
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X RN195971 GA Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

PO Box 603484
Charlotte, NC 28260-3484
Phone (803) 765-1838

Other practice location 1

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 794-0477

Other practice location 2

146 Bill Carruth Pkwy
Hiram, GA 30141-3749
Phone (770) 794-0477

Other practice location 3

184 Holly Springs Rd NE
White, GA 30184-2731
Phone (770) 382-1530

Other practice location 4

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 794-0477

Other practice location 5

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (770) 794-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170809002395 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123399193 Reassigns benefits to 3 organizations
I20250428001833 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123399193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dpi of Georgia LLCGroup PAC ID 0941546923, 30 clinicians

Practice addresses (Care Compare)

300 Colonial Ctr Pkwy
Suite 100N
Roswell, GA 30076-4892
Phone (225) 923-0030

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Ezzy CurrentSince Feb 15, 2020 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Nurse Anesthetist, Certified Registered CurrentSince May 22, 2025 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince May 22, 2025 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
CSP Anesthesia LLC CurrentSince Feb 1, 2020 Accepting new patients
Dpi of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2019 Accepting new patients
Georgia Interventional Pain - D LLC Past Accepting new patients
Mak Anesthesia Holdings LLC PastSince Jan 28, 2023 Accepting new patients

Locations

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

484 Irvin Ct
Ste 130
Decatur, GA 30030

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

455 Philip Blvd
Ste 138
Lawrenceville, GA 30046

892 Legacy Park Dr
Lawrenceville, GA 30043

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

300 Colonial Center Pkwy
Ste 100N
Roswell, GA 30076
Phone (704) 684-7609

1357 Hembree Rd
Ste 230
Roswell, GA 30076
Phone (770) 740-9664

403 Permian Way
Ste D
Villa Rica, GA 30180
Phone (470) 827-3648

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

8536 Palmetto Commerce Pkwy
Ste 501
Ladson, SC 29456
Phone (843) 203-2260

Organizations & group practices 8

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": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1215374426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603484",
            "telephone_number": "803-765-1838",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "146 Bill Carruth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413749",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "184 Holly Springs Rd NE",
            "address_purpose": "LOCATION",
            "city": "White",
            "state": "GA",
            "postal_code": "301842731",
            "country_code": "US",
            "telephone_number": "770-382-1530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "677 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "JUSTIN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-29",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN195971",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN195971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.