Individual provider Active NPI

Michael Paul Greenage, D.O.

  • Psychiatry Physician
  • Christiansburg, VA
National Provider Identifier
1750589917
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0102-203679 Issued in VA
Practice address
2900 Tyler Rd
Christiansburg, VA 24073-6374
Phone
(540) 731-7311
Fax
(540) 731-7377
NPI assigned
Jul 10, 2007
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS015524 PA
Psychiatry Physician 2084P0800X 0116019686 VA
Psychiatry Physician 2084P0800X 0102-203679 VA Primary

Addresses

Primary practice location

2900 Tyler Rd
Christiansburg, VA 24073-6374

Mailing address

2900 Tyler Rd
Christiansburg, VA 24073-6374
Phone (540) 731-7311

Other identifiers 1

IdentifierTypeStateIssuer
VVB891AOtherVAMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgreenage16968@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20131231001215 VA Practitioner - Psychiatry 9234307562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015524PAMDPsychiatry Physician
0116019686VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 21, 2013 Accepting new patients
Blue Ridge Behavioral Healthcare CurrentSince Jan 23, 2014 Accepting new patients
Carilion Medical Center CurrentSince Oct 21, 2013 Accepting new patients

Locations

2900 Tyler Rd
Christiansburg, VA 24073
Phone (540) 731-7311

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

301 Elm Ave SW
Roanoke, VA 24016
Phone (540) 266-9200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1750589917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 TYLER RD",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240736374",
            "telephone_number": "540-731-7311",
            "fax_number": "540-731-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 TYLER RD",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240736374",
            "telephone_number": "540-731-7311",
            "fax_number": "540-731-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAGE",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS015524",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0116019686",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102-203679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "VVB891A",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgreenage16968@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mgreenage16968@direct.carilionclinic.org",
            "address_1": "2900 Tyler Rd",
            "city": "Christiansburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240736374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Christiansburg, VA

Sources for this page

Verify at the official NPI Registry.