Individual provider Active NPI

Greshma Susan George

  • Pediatrics Physician
  • Huntington, IN
National Provider Identifier
1356828065
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01085076A Issued in IN
Practice address
2003 Stults Rd Ste 105
Huntington, IN 46750-1291
Phone
(260) 355-3250
NPI assigned
Jul 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 01085076A IN Primary

Addresses

Primary practice location

2003 Stults Rd Ste 105
Huntington, IN 46750-1291

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-2156

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ggeorge453444@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629002942 IN Practitioner - Pediatric Medicine 5991106866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01085076AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Health System Inc Pediatrics CurrentSince Jul 1, 2021 Accepting new patients

Locations

817 Trail Ridge Rd
Albion, IN 46701
Phone (260) 373-9590

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

2003 Stults Rd
Ste 105
Huntington, IN 46750
Phone (260) 355-3250

Interoperability endpoints

  • Direct secure messaging: ggeorge453444@direct.parkviewexchange.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1356828065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 STULTS RD STE 105",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467501291",
            "telephone_number": "260-355-3250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Broadway",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731329",
            "country_code": "US",
            "telephone_number": "718-334-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSAN GEORGE",
        "first_name": "GRESHMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-25",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01085076A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggeorge453444@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "2003 Stults Rd Ste 105",
            "city": "Huntington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467501291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2003 Stults Rd Ste 105",
            "city": "Huntington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467501291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2003 Stults Rd Ste 105",
            "city": "Huntington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "467501291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, IN

Sources for this page

Verify at the official NPI Registry.