CHARLES C GREENE MD PHD PA (NPI# 1598014805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598014805 |
| Entity Type | Organization |
| Organization Name | CHARLES C GREENE MD PHD PA |
| Other Organization Name | JACKSONVILLE ENT SURGERY CENTER |
| Practice Address |
789 W Duval St Lake City FL 32055-3811 |
| Mailing Address |
Po Box 864935 Orlando FL 32886-4935 |
| Practice Telephone | 9044192054 |
| Mailing Telephone | 9044192054 |
| Mailing Fax Number | 9044192057 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2013-06-04 |
| Authorized Official Name | CHARLES C GREENE (OWNER) |
| Authorized Official Telephone | 9126915711 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Jacksonville ENT Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457600769 | Charles C Greene Md Phd Pa | Otolaryngology | 11512 Lake Mead Ave, Ste 531, Jacksonville, FL 32256-9733 | 2012-08-31 |
| 1609125913 | Charles C Greene Md Phd Pa | Otolaryngology | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2012-08-31 |
| 1942559265 | Charles C Greene Md Phd Pa | Otolaryngology | 11512 Lake Mead Ave, Ste 531, Jacksonville, FL 32256-9680 | 2012-08-31 |
| Street Address |
789 W DUVAL ST |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497754154 | Andres R Villar Md | Clinic/Center | 789 W Duval St, Lake City, FL 32055-3811 | 2005-07-15 |
| 1265993091 | Jackie Renee Manning | Nurse Practitioner | 789 W Duval St, Lake City, FL 32055-3811 | 2019-03-26 |
| 1730695248 | Elena Guzman Meredith | Nurse Practitioner | 789 W Duval St, Lake City, FL 32055-3811 | 2017-12-19 |
| 1487005005 | Patricia Carr | Nurse Practitioner | 789 W Duval St, Lake City, FL 32055-3811 | 2016-06-24 |
| 1467881300 | Megan Marie Contini | Nurse Practitioner | 789 W Duval St, Lake City, FL 32055-3811 | 2013-11-01 |
| 1427125681 | Sharon Baldauf-madero | Physician Assistant | 789 W Duval St, Lake City, FL 32055-3811 | 2006-11-30 |
| 1295741221 | Robert Leonard Yelken | Physician Assistant | 789 W Duval St, Lake City, FL 32055-3811 | 2006-07-31 |
| 1164421855 | Andres R Villar | Pediatrics | 789 W Duval St, Lake City, FL 32055-3811 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184789893 | Berge Marcarian | Otolaryngology | 4551 W Us Highway 90, Suite 101, Lake City, FL 32055-4879 | 2006-12-22 |
| 1962739334 | W.eric Loch,m.d.,p.a. | Otolaryngology | 4551 W Us Highway 90, Suite 101, Lake City, FL 32055-8836 | 2009-11-05 |
| 1851456560 | Berge Marcarian, M.d., P.a. | Otolaryngology | 4551 W Us Highway 90, Suite 101, Lake City, FL 32055-4879 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447870977 | Shanmugasundaram, Venkatachalam | Otolaryngology | 10131 W Forest Hill Blvd Ste 201, Wellington, FL 33414-6109 | 2020-04-24 |
| 1851910517 | Daniel Oswaldo Manrique | Otolaryngology | 325 Saddle Ridge Dr, Davenport, FL 33896-8176 | 2020-04-13 |
| 1932735768 | Martin Alvin Shugar | Otolaryngology | 3850 Hollywood Blvd Ste 401, Hollywood, FL 33021-6746 | 2020-03-12 |
| 1396219242 | North Broward Hospital Distric T | Otolaryngology | 1801 W Sample Rd Ste 101, Deerfield Beach, FL 33064-1370 | 2019-01-14 |
| 1356811194 | Donald Lee Roberts | Otolaryngology | 4251 Commons Dr W Unit 5211, Destin, FL 32541-8636 | 2018-12-04 |
| 1275022238 | Mary Teresa Garrish | Otolaryngology | 405 Sims Way, Merritt Island, FL 32952-5233 | 2018-05-05 |
| 1437658671 | Baptist Ent Specialists Inc | Otolaryngology | 11236 Baptist Health Dr Ste 330, Jacksonville, FL 32218-2989 | 2018-02-02 |
| 1467970368 | Portela E.n.t., Pa | Otolaryngology | 3100 Sw 62nd Ave Ste 124, Miami, FL 33155-3009 | 2017-08-31 |
| 1427414358 | Rufus Madison Holloway Jr. | Otolaryngology | 1616 Lake Shore Drive, Orlando, FL 32803 | 2016-01-07 |
| 1609253178 | Sumeet Bhanot Md Pa | Otolaryngology | 2038 Bee Ridge Road, Suite A, Sarasota, FL 34239 | 2015-05-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.