Active NPI
Susan L Greenwald, MD
- Pediatrics Physician
- Kearney, NE
National Provider Identifier
1306920186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 17725
- Practice address
- 211 West 33Rd Street
Kearney, NE 68845 - Phone
- (308) 865-2141
- Fax
- (308) 234-7582
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17725 | NE | Primary |
Addresses
Primary practice location
211 West 33Rd Street
Kearney, NE 68845
Mailing address
PO Box 670
Kearney, NE 68848
Phone (308) 865-2141
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47064194537 | Medicaid | NE | |
| 03349 | Other | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17725 | NE | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306920186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 670",
"city": "KEARNEY",
"state": "NE",
"postal_code": "68848",
"telephone_number": "308-865-2141",
"fax_number": "308-234-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 WEST 33RD STREET",
"city": "KEARNEY",
"state": "NE",
"postal_code": "68845",
"telephone_number": "308-865-2141",
"fax_number": "308-234-7582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWALD",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "17725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47064194537",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "03349",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.