DR. JEFFREY D GREENBAUM (NPI# 1649383001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649383001 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY D GREENBAUM |
| Credential | MD |
| Practice Address |
625 E Broadway St Jackson WY 83001-0428 |
| Mailing Address |
Po Box 428 625 E Broadway Jackson WY 83001-0428 |
| Practice Telephone | 3077333636 |
| Mailing Telephone | 3077333636 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
6444A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 115562800 | 05 |
| Street Address |
625 E BROADWAY ST |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-0428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033225354 | Richard A Mckay | Emergency Medicine | 625 E Broadway St, Jackson, WY 83001 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447469135 | Alton Parker | Emergency Medicine | 555 E. Broadway #212, Jackson, WY 83001 | 2007-05-21 |
| 1174569107 | Gregory W Fuller | Emergency Medicine | 1006 Airport Rd, Jackson, MI 49202-1851 | 2006-06-20 |
| 1417318361 | Jacob Robert Russell | Emergency Medicine | 620 Skyline Dr, Jackson, TN 38301 | 2016-03-18 |
| 1972836294 | Independent Observation Physicians Pllc | Emergency Medicine | 205 N East Ave, Jackson, MI 49201-1753 | 2009-09-18 |
| 1700119500 | Independent Observation Physicians Pllc | Emergency Medicine | 205 N East Ave, Jackson, MI 49201-1753 | 2009-09-10 |
| 1538345855 | Emergency Medical Care Facilities PC | Emergency Medicine | 620 Skyline Dr, Jackson, TN 38301-3923 | 2008-01-16 |
| 1881891786 | James Plemon Coleman II | Emergency Medicine | 2500 N State St, Jackson, MS 39216-4500 | 2007-07-02 |
| 1033225354 | Richard A Mckay | Emergency Medicine | 625 E Broadway St, Jackson, WY 83001 | 2006-08-21 |
| 1003922360 | William R Smith | Emergency Medicine | 625 E Broadway, Jackson, WY 83001 | 2006-08-21 |
| 1780797050 | Albert R Wheeler IIi | Emergency Medicine | 625 E Broadway, Jackson, WY 83001-0428 | 2006-08-17 |
| Find all providers in JACKSON | ||||
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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.