Wiley A Greene, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104000940 Issued in VA

Practice address

1914 Euclid Ave
Bristol, VA 24201-3608

Phone

(276) 642-0107

Fax

(276) 642-0347

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1396793147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 EUCLID AVE",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013608",
            "telephone_number": "276-642-0107",
            "fax_number": "276-642-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 EUCLID AVE",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013608",
            "telephone_number": "276-642-0107",
            "fax_number": "276-642-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "WILEY",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6708935",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bristol, VA
• Providers in Bristol, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.