Individual provider Active NPI

Jeannette Marie Greer-Brumbaugh, M.D.

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1255481693
Registry record updated Oct 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
H6256 Issued in TX
Practice address
2450 Fondren Rd
Suite 311
Houston, TX 77063-2318
Phone
(713) 621-8660
Fax
(713) 621-3730
NPI assigned
Jan 10, 2007
Last updated
Oct 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X H6256 TX Primary

Addresses

Primary practice location

2450 Fondren Rd
Suite 311
Houston, TX 77063-2318

Mailing address

2450 Fondren Rd
Suite 311
Houston, TX 77063-2318
Phone (713) 621-8660

Other identifiers 1

IdentifierTypeStateIssuer
H6256OtherTXSTATE LICENSE

Other names 1

  • Dr. Jeannette Marie Greer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130624000675 TX Order and Referring Only - DermatologyPractitioner - Dermatology 5799924791

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318032000000",
    "number": "1255481693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 FONDREN RD",
            "address_2": "SUITE 311",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770632318",
            "telephone_number": "713-621-8660",
            "fax_number": "713-621-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 FONDREN RD",
            "address_2": "SUITE 311",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770632318",
            "telephone_number": "713-621-8660",
            "fax_number": "713-621-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREER-BRUMBAUGH",
        "first_name": "JEANNETTE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "H6256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "H6256",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNETTE",
            "last_name": "GREER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.