Active NPI
Ray S Greco II, D.O.
- Gynecology Physician
- Covington, GA
National Provider Identifier
1942264569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 25756
- Practice address
- 4143 Hospital Dr NE
Covington, GA 30014-2565 - Phone
- (770) 787-2674
- Fax
- (770) 787-6222
- NPI assigned
- Apr 12, 2006
- 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 25756 | GA | Primary |
Addresses
Primary practice location
4143 Hospital Dr NE
Covington, GA 30014-2565
Mailing address
4143 Hospital Dr NE
Covington, GA 30014-2565
Phone (770) 787-2674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000280266A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942264569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4143 HOSPITAL DR NE",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300142565",
"telephone_number": "770-787-2674",
"fax_number": "770-787-6222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4143 HOSPITAL DR NE",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300142565",
"telephone_number": "770-787-2674",
"fax_number": "770-787-6222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRECO",
"first_name": "RAY",
"middle_name": "S",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "25756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000280266A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.