Stacy Greeter, MD, PLLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

ME 128423 Issued in FL

Legal business name

STACY GREETER, MD, PLLC

Practice address

9030 58TH Dr E
Suite 101a, Room a
Bradenton, FL 34202-6108

Phone

(941) 413-0834

Fax

(941) 761-5547

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Stacy Lynn Greeter, MD

Title

Physician

Phone

(904) 228-0777

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1700311818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E",
            "address_2": "SUITE 101A, ROOM A",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-413-0834",
            "fax_number": "941-761-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E",
            "address_2": "SUITE 101A, ROOM A",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-413-0834",
            "fax_number": "941-761-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY GREETER, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "GREETER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "904-228-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": "ME 128423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1215257845",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.