Organization Active NPI

Greceannii Healthcare P C

  • Gerontology Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1356069850
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
GRECEANNII HEALTHCARE P C
Practice address
7130 Minstrel Way Ste 120
Columbia, MD 21045-5329
Phone
(443) 241-7622
NPI assigned
Aug 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Max Greceannii
Title
Ceo
Phone
(314) 922-4937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LG0600X Primary

Addresses

Primary practice location

7130 Minstrel Way Ste 120
Columbia, MD 21045-5329

Mailing address

7130 Minstrel Way Ste 120
Columbia, MD 21045-5329
Phone (314) 922-4937

Other practice location 1

9416 Falling Waters Ct
Laurel, MD 20723-5973
Phone (314) 922-4937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220915003307 MD Part B Supplier - Clinic/Group Practice 6901281682 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2276010Greceannii Healthcare PC7130 Minstrel Way, #120, Columbia, MD 21045Certificate of waiverJan 31, 2027

National Provider Directory

National Provider Directory

Locations

7130 Minstrel Way
Ste 120
Columbia, MD 21045
Phone (410) 224-6680

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1356069850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 MINSTREL WAY STE 120",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455329",
            "telephone_number": "314-922-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 MINSTREL WAY STE 120",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455329",
            "telephone_number": "443-241-7622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9416 Falling Waters Ct",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207235973",
            "country_code": "US",
            "telephone_number": "314-922-4937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRECEANNII HEALTHCARE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-19",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "GRECEANNII",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-922-4937"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.