Organization Active NPI

Robert W Greene Jr MD PC

  • Physical Medicine & Rehabilitation Physician
  • Memphis, TN
National Provider Identifier
1457520868
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD019597 Issued in TN
Legal business name
ROBERT W GREENE JR MD PC
Practice address
220 S Claybrook St
Suite 500
Memphis, TN 38104-3527
Phone
(901) 722-5833
Fax
(901) 722-5837
NPI assigned
Feb 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Mrs. Sally B Greene
Title
Practice Administrator
Phone
(901) 722-5833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MD019597 TN Primary

Addresses

Primary practice location

220 S Claybrook St
Suite 500
Memphis, TN 38104-3527

Mailing address

220 S Claybrook St
Suite 500
Memphis, TN 38104-3527
Phone (901) 722-5833

Other identifiers 1

IdentifierTypeStateIssuer
3047082MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080429000508 TN Part B Supplier - Clinic/Group Practice 0840378022 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory
Tax ID family
Robert W Greene Jr MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6005 Park Ave
Ste 804
Memphis, TN 38119
Phone (901) 680-9377

6005 Park Ave
Ste 112
Memphis, TN 38119
Phone (901) 761-5885

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1457520868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S CLAYBROOK ST",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043527",
            "telephone_number": "901-722-5833",
            "fax_number": "901-722-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S CLAYBROOK ST",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043527",
            "telephone_number": "901-722-5833",
            "fax_number": "901-722-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W GREENE JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-722-5833",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "MD019597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3047082",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.