Active NPI
Clyve Greaves Jr., M.D.
- Internal Medicine Physician
- Mather, CA
National Provider Identifier
1740423722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A109263
- Practice address
- 10535 Hospital Way
Mather, CA 95655-4200 - Phone
- (916) 843-9057
- NPI assigned
- Apr 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A109263 | CA | Primary |
Addresses
Primary practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
10535 Hospital Way
Mather, CA 95655-4200
Phone (916) 843-9057
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A109263 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1740423722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-9057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-9057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREAVES",
"first_name": "CLYVE",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-07",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A109263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.