CHARLES C GREENE MD PHD PA (NPI# 1609125913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609125913 |
| Entity Type | Organization |
| Organization Name | CHARLES C GREENE MD PHD PA |
| Other Organization Name | JACKSONVILLE ENT SURGERY CENTER |
| Practice Address |
6484 Fort Caroline Rd Jacksonville FL 32277-2042 |
| Mailing Address |
Po Box 864935 Orlando FL 32886-4935 |
| Practice Telephone | 9044192054 |
| Practice Fax Number | 9044192057 |
| 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 |
| 1942559265 | Charles C Greene Md Phd Pa | Otolaryngology | 11512 Lake Mead Ave, Ste 531, Jacksonville, FL 32256-9680 | 2012-08-31 |
| 1598014805 | Charles C Greene Md Phd Pa | Otolaryngology | 789 W Duval St, Lake City, FL 32055-3811 | 2012-08-31 |
| Street Address |
6484 FORT CAROLINE RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32277-2042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144222696 | Elaine G Holmes | Family Medicine | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2005-08-15 |
| 1225656085 | Kameron David Mullaney | Physician Assistant | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2020-07-08 |
| 1356998280 | Chima Ekwueme | Nurse Practitioner | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2019-08-26 |
| 1033609789 | Anissa Brisbane-mcfadden | Nurse Practitioner | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2018-05-17 |
| 1669913448 | Lalita Kummeth | Nurse Practitioner | 6484 Fort Caroline Rd, Jacksonville, FL 32277 | 2017-03-14 |
| 1386017689 | Amanda Dupree | Nurse Practitioner | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2015-11-09 |
| 1750761094 | Andrew Jervey Hunt | Family Medicine | 6484 Fort Caroline Rd, Jacksonville, FL 32277 | 2015-06-02 |
| 1407259476 | Carolyn Mcclinton | Nurse Practitioner | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2014-10-03 |
| 1659773562 | James Beatty | Physician Assistant | 6484 Fort Caroline Rd, Jacksonville, FL 32277-2042 | 2014-09-23 |
| 1629310909 | Arun Joseph | Pediatrics | 6484 Fort Caroline Rd, Jacksonville, FL 32277 | 2013-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1376042176 | Seginald Rashaad Chaney | Adult Companion | 5885 Edenfield Rd, Charter Landing Apartments Apt E-10, Jacksonville, FL 32277 | 2018-02-07 |
| 1578966875 | Erin Chretien | Behavioral Analyst | 3780 University Club Blvd Apt 3204, Jacksonville, FL 32277 | 2014-09-30 |
| 1518300128 | Michel Joseph Sabra | Surgery | 5053 Toproyal Ln, Jacksonville, FL 32277 | 2013-04-12 |
| 1982977443 | A1 Care Systems Inc | Assisted Living Facility | 7449 Sandhurst Rd S, Jacksonville, FL 32277 | 2012-02-14 |
| 1851453211 | Ajay Doddapaneni | Radiology | 7920 Merrill Rd Unit 708, Jacksonville, FL 32277 | 2006-12-14 |
| 1821184565 | Ramsey Bader Salem | Dentist | 6237 Merrill Road, Jacksonville, FL 32277 | 2006-10-04 |
| 1164697157 | Brianne Graves | Psychologist | 3517 Peeler Rd, Unit 11, Jacksonville, FL 32277-0616 | 2008-04-29 |
| 1407217391 | Kathleen Bashore | Occupational Therapy Assistant | 8057 Le Havre Dr N, Jacksonville, FL 32277-0902 | 2016-03-18 |
| 1518431394 | Daniel Corristan | Specialist/Technologist | 7721 Leesburg Dr S, Jacksonville, FL 32277-0925 | 2019-01-15 |
| Find all providers in zip 32277 | ||||
| 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 |
|---|---|---|---|---|
| 1437658671 | Baptist Ent Specialists Inc | Otolaryngology | 11236 Baptist Health Dr Ste 330, Jacksonville, FL 32218-2989 | 2018-02-02 |
| 1740562875 | Onslow Ambulatory Services, Inc. | Otolaryngology | 55 Office Park Dr, Jacksonville, NC 28546-7327 | 2011-09-14 |
| 1225317217 | Joseph Fares Md Pa | Otolaryngology | 4306 University Blvd S, Jacksonville, FL 32216-4910 | 2011-08-09 |
| 1720394695 | Rodolfo Enrique Manosalva | Otolaryngology | 554 Keily St., Jacksonville, FL 32212-5000 | 2010-08-29 |
| 1700060555 | Iman Naseri | Otolaryngology | 6817 Southpoint Parkway, Suite 502, Jacksonville, FL 32216-6289 | 2007-12-27 |
| 1366504342 | Dayananda Mulur Shetty | Otolaryngology | 9831 Del Webb Parkway, #2305, Jacksonville, FL 32256-5807 | 2006-12-15 |
| 1255406898 | Justin Randolph Moy | Otolaryngology | 14546 Old Saint Augustine Rd Ste 301, Jacksonville, FL 32258-5472 | 2006-11-21 |
| 1427122118 | Joseph Fares | Otolaryngology | 4306 University Blvd South, Jacksonville, FL 32216 | 2006-11-17 |
| 1952470874 | Lawrence Albert Lisska | Otolaryngology | 4130 Salisbury Rd, Suite 1900, Jacksonville, FL 32216-8031 | 2006-11-07 |
| 1558376004 | Advanced Otolaryngology Services Pa | Otolaryngology | 3627 University Blvd S Ste 210, Jacksonville, FL 32216-4256 | 2006-07-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32277 |
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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.