Organization Active NPI

Kenneth M. Greene, M.D. & Associates

  • Specialist
  • Baltimore, MD
National Provider Identifier
1760680888
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0037016 Issued in MD
Legal business name
KENNETH M. GREENE, M.D. & ASSOCIATES
Practice address
6701 N Charles St
Suite 4104
Baltimore, MD 21204-6808
Phone
(410) 821-2800
Fax
(410) 821-2804
NPI assigned
Jul 10, 2007
Last updated
Nov 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
Mrs. Debra Lee Huskey
Title
Office Manager
Phone
(410) 821-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0037016 MD Primary

Addresses

Primary practice location

6701 N Charles St
Suite 4104
Baltimore, MD 21204-6808

Mailing address

6701 N Charles St
Suite 4104
Baltimore, MD 21204-6808
Phone (410) 821-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100318000469 MD Part B Supplier - Clinic/Group Practice 9335274125 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1760680888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "address_2": "SUITE 4104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-821-2800",
            "fax_number": "410-821-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "address_2": "SUITE 4104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-821-2800",
            "fax_number": "410-821-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH M. GREENE, M.D. & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "HUSKEY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-821-2800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0037016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.