Greenbriar Primary Care, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201255 Issued in NC

Legal business name

GREENBRIAR PRIMARY CARE, PA

Practice address

308-C Mocksville Highway
Statesville, NC 28625

Phone

(704) 873-4484

Fax

(704) 873-4485

NPI assigned

Jun 8, 2009

Last updated

Aug 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Judy L Keighron, NPNPI 1073739843

Title

President

Phone

(704) 873-4484

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Judy Lackey Keighron, FNP-BC

  • Family Nurse Practitioner
  • Statesville, NC
  • NPI 1073739843
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1477789147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308-C MOCKSVILLE HIGHWAY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258267",
            "telephone_number": "704-873-4484",
            "fax_number": "704-873-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308-C MOCKSVILLE HIGHWAY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28625",
            "telephone_number": "704-873-4484",
            "fax_number": "704-873-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIAR PRIMARY CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "KEIGHRON",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-873-4484",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga V Gray, FNP
• Aaliyyah Green, LPN
• Crystal Medley Green, FNP
• Elizabeth Green
• Patricia Green, MS,CCC-SLP
• Elisa Pharr Greene
• Greens at Maple Leaf LLC
• Lisa Greer
• Gregory J. Kuchtjak, D.M.D., P.a.
• Brittany Nicole Griffin, FNP

• Family Nurse Practitioner in Statesville, NC
• Providers in Statesville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; 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.