Active NPI
Carroll H Greene III, PHD
- Clinical Psychologist
- New Bern, NC
National Provider Identifier
1255397626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 5282
- Practice address
- 6017 Cassowary LN
New Bern, NC 28560-7170 - Phone
- (252) 288-4681
- NPI assigned
- Apr 25, 2006
- Last updated
- Nov 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810001484 | VA | |
| Clinical Psychologist | 103TC0700X | PY 5282 | FL | Primary |
Addresses
Primary practice location
6017 Cassowary LN
New Bern, NC 28560-7170
Mailing address
6017 Cassowary LN
New Bern, NC 28560-7170
Phone (252) 288-4681
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 5282 | FL | MD | Clinical Psychologist |
| 0810001484 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1255397626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6017 CASSOWARY LN",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285607170",
"telephone_number": "252-288-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6017 CASSOWARY LN",
"city": "NEW BERN",
"state": "NC",
"postal_code": "285607170",
"telephone_number": "252-288-4681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "CARROLL",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810001484",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 5282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bern, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.