NPIMap

Organization Active NPI

Charles C Greene, MD, PHD

Doing business as Jacksonville ENT Surgery Center

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1235576091
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CHARLES C GREENE, MD, PHD
Doing business as
Jacksonville ENT Surgery Center
Practice address
4131 University Blvd S
Building 18
Jacksonville, FL 32216-4326
Phone
(904) 419-2054
NPI assigned
Jun 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Dr. Charles C Greene, MD, PHD
Title
Owner
Phone
(904) 419-2054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4131 University Blvd S
Building 18
Jacksonville, FL 32216-4326

Mailing address

11512 Lake Mead Ave
Suite 531
Jacksonville, FL 32256-9680
Phone (904) 419-2054

Other names 1

  • Jacksonville ENT Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Charles C Greene MD PHD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1235576091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11512 LAKE MEAD AVE",
            "address_2": "SUITE 531",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569680",
            "telephone_number": "904-419-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S",
            "address_2": "BUILDING 18",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164326",
            "telephone_number": "904-419-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES C GREENE, MD, PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-419-2054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville ENT Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.