Individual provider Active NPI

Brad Andrew Greenbaum, M.D.

  • Pediatrics Physician
  • Nashville, TN
National Provider Identifier
1801889274
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30181 Issued in TN
Practice address
342 21St Ave N
Nashville, TN 37203-1848
Phone
(615) 327-9371
Fax
(615) 329-6652
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30181 TN Primary

Addresses

Primary practice location

342 21St Ave N
Nashville, TN 37203-1848

Mailing address

342 21St Ave N
Nashville, TN 37203-1848
Phone (615) 327-9371

Other identifiers 6

IdentifierTypeStateIssuer
00001807489 01OtherTNUNITEDHEALTHCARE
079138OtherTNAETNA
G75193OtherTNHEALTHSPRINGS
110784OtherTNCIGNA
3101080OtherTNBLUE CROSS
3824681MedicaidTN

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

LicenseStateTypeSpecialty
30181TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HCA Health Services of Tennessee, Inc. Past Accepting new patients
Saint Thomas West Hospital Past Accepting new patients
Terrace Pediatric Group LLC Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1801889274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 21ST AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031848",
            "telephone_number": "615-327-9371",
            "fax_number": "615-329-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 21ST AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031848",
            "telephone_number": "615-327-9371",
            "fax_number": "615-329-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "BRAD",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "30181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "00001807489 01",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "079138",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRINGS",
            "identifier": "G75193",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "110784",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3101080",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3824681",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.