Active NPI
Miggie L Greenberg, MD
- Psychiatry Physician
- Saint Louis, MO
National Provider Identifier
1841216702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2001010861
- Practice address
- 1221 S Grand
St Louis, MO 63104 - Phone
- (314) 577-8720
- Fax
- (314) 268-5494
- NPI assigned
- Jul 14, 2006
- Last updated
- Mar 18, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2001010861 | MO | Primary |
Addresses
Primary practice location
1221 S Grand
St Louis, MO 63104
Mailing address
3691 Rutger Ave
Provider Enrollment
St Louis, MO 63110
Phone (314) 977-4440
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001010861 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SLH Vista, Inc. | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1841216702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3691 RUTGER AVE",
"address_2": "PROVIDER ENROLLMENT",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63110",
"telephone_number": "314-977-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 S GRAND",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63104",
"telephone_number": "314-577-8720",
"fax_number": "314-268-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "MIGGIE",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2001010861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.