Jerry Lee Greenburg, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

018166 Issued in CT

Practice address

131 Kings Highway North
Westport, CT 06880-2429

Phone

(203) 227-0805

Fax

(203) 227-0808

NPI assigned

Dec 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gastroenterology and Internal Medicine of Westport PC

  • Gastroenterology Physician
  • Westport, CT
  • NPI 1447464144
  NPD (past) Authorized official

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417010695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 KINGS HIGHWAY NORTH",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802429",
            "telephone_number": "203-227-0805",
            "fax_number": "203-227-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 KINGS HIGHWAY NORTH",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068802429",
            "telephone_number": "203-227-0805",
            "fax_number": "203-227-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBURG",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "018166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Gray, LPCA
• Greater New England Human Services Group, Inc.
• Shayna Fortes Green, MA, LPCA, NCC
• Thomas Michael Green
• Gayle Greenberger, LPC
• Diane Greenhill, LCSW
• Greenleaf Psychiatry
• Barbara Ann Greenspan, MS, OTR
• Abby Greenspun, MS, RD, CDN
• Deborah Gruen, PH.D.

• Gastroenterology Physician in Westport, CT
• Providers in Westport, CT by specialty
• Gastroenterology Physician in Connecticut

• 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.

Verify at the official NPI Registry.