Active NPI
Lynn F Greenlee, M.D.
- Ophthalmology Physician
- Canon City, CO
National Provider Identifier
1326099870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 17215
- Practice address
- 1145 Ohio Ave
Canon City, CO 81212-2278 - Phone
- (719) 275-7481
- Fax
- (719) 275-0059
- NPI assigned
- May 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 17215 | CO | Primary |
Addresses
Primary practice location
1145 Ohio Ave
Canon City, CO 81212-2278
Mailing address
27 Montebello Rd
Pueblo, CO 81001-1236
Phone (719) 545-1530
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01172154 | Medicaid | CO | |
| CO7215 | Other | CO | EYE MED EYECARE |
| K2038 | Other | CO | ANTHEM |
| 841207157 | Other | CO | UNITED HEALTHCARE |
| 182042704 | Other | CO | RAILROAD MEDICARE |
| K2038 | Other | CO | FEDERAL BCBS |
| 920726020820 | Other | CO | EYE SPECIALISTS |
| 608439600 | Other | CO | US DEP LABOR WORK COM |
| 0452890001 | Other | CO | MEDICARE DMERC |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17215 | CO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326099870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 MONTEBELLO RD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011236",
"telephone_number": "719-545-1530",
"fax_number": "719-545-2899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 OHIO AVE",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122278",
"telephone_number": "719-275-7481",
"fax_number": "719-275-0059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENLEE",
"first_name": "LYNN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CO",
"license": "17215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01172154",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED EYECARE",
"identifier": "CO7215",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "K2038",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "841207157",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "182042704",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BCBS",
"identifier": "K2038",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE SPECIALISTS",
"identifier": "920726020820",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEP LABOR WORK COM",
"identifier": "608439600",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DMERC",
"identifier": "0452890001",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
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.