Organization Active NPI

David Greene MD LLC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Naples, FL
National Provider Identifier
1619256385
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
ME78059 Issued in FL
Legal business name
DAVID GREENE MD LLC
Practice address
1112 Goodlette Rd N
Suite 203
Naples, FL 34102-5474
Phone
(239) 263-8444
Fax
(239) 263-6120
NPI assigned
Aug 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
David Greene, MDNPI 1043262389
Title
Owner
Phone
(239) 216-6542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0007X ME78059 FL Primary

Addresses

Primary practice location

1112 Goodlette Rd N
Suite 203
Naples, FL 34102-5474

Mailing address

1112 Goodlette Rd N
Suite 203
Naples, FL 34102-5497
Phone (239) 216-6542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110929000433 FL Part B Supplier - Clinic/Group Practice 4284805953 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

1112 Goodlette Rd
Ste 203
Naples, FL 34102
Phone (239) 263-8444

2430 Vanderbilt Beach Rd
Ste 108
Naples, FL 34109
Phone (239) 287-6624

Practitioners & affiliated clinicians

Practitioners 6

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": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1619256385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 GOODLETTE RD N",
            "address_2": "SUITE 203",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025497",
            "telephone_number": "239-216-6542",
            "fax_number": "239-263-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 GOODLETTE RD N",
            "address_2": "SUITE 203",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025474",
            "telephone_number": "239-263-8444",
            "fax_number": "239-263-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID GREENE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-216-6542",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "ME78059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.