Individual provider Active NPI

Justin Stuart Greenlee, D.O.

  • Family Medicine Physician
  • West Union, OH
National Provider Identifier
1467655647
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34008782 Issued in OH
Practice address
90 Cic Blvd
West Union, OH 45693-8024
Phone
(937) 544-8989
Fax
(937) 544-5659
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34008782 OH Primary

Addresses

Primary practice location

90 Cic Blvd
West Union, OH 45693-8024

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-8681

Other identifiers 2

IdentifierTypeStateIssuer
2761382MedicaidOH
7100020960MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justin.greenlee@somc.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070911000157 OH Practitioner - Family Practice 1658464466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8117

90 Cic Blvd
West Union, OH 45693-8024
Phone (937) 544-8989

Hospital & facility affiliations

  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008
  • Adams County Regional Medical Center Hospital, Seaman, OH, CCN 361326

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34008782OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. CurrentSince Dec 4, 2010 Accepting new patients
Somc Medical Care Foundation, Inc. Family Medicine CurrentSince Dec 4, 2010 Accepting new patients
Somc Medical Care Foundation, Inc. Current Accepting new patients

Locations

10 Thomas Hollow Rd
Lucasville, OH 45648
Phone (740) 259-5699

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1735 27th St
Ste 302
Portsmouth, OH 45662
Phone (740) 355-8562

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

90 Cic Blvd
West Union, OH 45693
Phone (937) 544-8989

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1467655647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CIC BLVD",
            "city": "WEST UNION",
            "state": "OH",
            "postal_code": "456938024",
            "telephone_number": "937-544-8989",
            "fax_number": "937-544-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "JUSTIN",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34008782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2761382",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100020960",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.greenlee@somc.medicity.net",
            "affiliation": "N",
            "address_1": "90 Cic Blvd",
            "city": "West Union",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456938024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Union, OH

Sources for this page

Verify at the official NPI Registry.