Individual provider Active NPI

Ralph Gillespie Greenlee Jr., MD

  • Neurology Physician
  • Fredericksburg, TX
National Provider Identifier
1255666772
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D5745 Issued in TX
Practice address
213 W Creek St
Fredericksburg, TX 78624-3732
Phone
(214) 695-2727
NPI assigned
Oct 16, 2009
Last updated
Oct 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D5745 TX Primary

Addresses

Primary practice location

213 W Creek St
Fredericksburg, TX 78624-3732

Mailing address

110 N Milam St # 120
Fredericksburg, TX 78624-3823
Phone (830) 864-5227

Other identifiers 1

IdentifierTypeStateIssuer
039258101MedicaidTX

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D5745TXMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1255666772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N MILAM ST # 120",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786243823",
            "telephone_number": "830-864-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W CREEK ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786243732",
            "telephone_number": "214-695-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "RALPH",
        "middle_name": "GILLESPIE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "D5745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039258101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.