Active NPI
Susan Walker Grey, MD
- Pulmonary Disease Physician
- Snellville, GA
National Provider Identifier
1467532325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 041571
- Practice address
- 1800 Tree Lane Road
Suite 200
Snellville, GA 30078 - Phone
- (770) 979-0367
- Fax
- (770) 979-0367
- NPI assigned
- Oct 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 041571 | GA | Primary |
Addresses
Primary practice location
1800 Tree Lane Road
Suite 200
Snellville, GA 30078
Mailing address
1800 Tree Lane Road
Suite 200
Snellville, GA 30078
Phone (770) 979-0367
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CO7170 | Other | GA | RAILROAD MEDICARE |
| GRP2664 | Other | GA | GROUP MEDICARE |
| 00711015A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastside Vascular Medicine and Surgery, P.C. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Snellville, GA
- NPI 1861676306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467532325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 TREE LANE ROAD",
"address_2": "SUITE 200",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "30078",
"telephone_number": "770-979-0367",
"fax_number": "770-979-1830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 TREE LANE ROAD",
"address_2": "SUITE 200",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "30078",
"telephone_number": "770-979-0367",
"fax_number": "770-979-0367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREY",
"first_name": "SUSAN",
"middle_name": "WALKER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "GA",
"license": "041571",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CO7170",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "GRP2664",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00711015A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- 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.