Active NPI
Mary Coffey Greist, MD
- Dermatopathology Physician
- Indianapolis, IN
National Provider Identifier
1306933858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology Physician
- License
- 01024873
- Practice address
- 6820 Parkdale Place
Suite 211
Indianapolis, IN 46254-6600 - Phone
- (317) 329-7050
- Fax
- (317) 328-6809
- NPI assigned
- Oct 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | 01024873 | IN | Primary |
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | 01024873 | IN |
Addresses
Primary practice location
6820 Parkdale Place
Suite 211
Indianapolis, IN 46254-6600
Mailing address
6820 Parkdale Place
Suite 211
Indianapolis, IN 46254-6600
Phone (317) 329-7050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000085208 | Other | IN | ANTHEM |
| 100060500 | Medicaid | IN |
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 |
|---|---|---|---|
| 01024873 | IN | MD | Dermatopathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Creek Dermatology | Clinical & Laboratory Dermatological Immunology | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
6820 Parkdale Pl
Ste 211
Indianapolis, IN 46254
Phone (317) 329-7050
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical & Laboratory Dermatological Immunology Physician
- Indianapolis, IN
- NPI 1053561928
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1306933858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6820 PARKDALE PLACE",
"address_2": "SUITE 211",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462546600",
"telephone_number": "317-329-7050",
"fax_number": "317-328-6809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6820 PARKDALE PLACE",
"address_2": "SUITE 211",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462546600",
"telephone_number": "317-329-7050",
"fax_number": "317-328-6809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREIST",
"first_name": "MARY",
"middle_name": "COFFEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "IN",
"license": "01024873",
"primary": true
},
{
"code": "207NI0002X",
"taxonomy_group": "",
"desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
"state": "IN",
"license": "01024873",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000085208",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100060500",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.