KEVIN CECIL GREENIDGE (NPI# 1174515118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174515118 |
| Entity Type | Individual |
| Full Name | KEVIN CECIL GREENIDGE |
| Credential | MD |
| Practice Address |
17001 Science Dr Ste 120 Bowie MD 20715-4330 |
| Mailing Address |
411 Walnut St # 15512 Green Cove Springs FL 32043-3443 |
| Practice Telephone | 3018601090 |
| Practice Fax Number | 3018601095 |
| Mailing Telephone | 7274323020 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2020-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | ME93458 | FL | Allopathic & Osteopathic Physicians |
| Y | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
D88314 | MD | Allopathic & Osteopathic Physicians |
| N | 207WX0009X |
Ophthalmology Specialization: Glaucoma Specialist |
ME93458 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 273351000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 148 13th St Sw, Largo, FL 337703127 | 7275818706 | 7275863743 |
| Street Address |
17001 SCIENCE DR STE 120 |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-4330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811419450 | Judy Chun Hu | Optometrist | 17001 Science Dr Ste 120, Bowie, MD 20715-4330 | 2017-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 207WX0009X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Glaucoma Specialist |
| An ophthalmologist who specializes in the treatment of glaucoma and other disorders related to increased intraocular pressure and optic nerve damage. This specialty involves the medical and surgical treatment of these conditions. |
| Notes: Source: American Academy of Ophthalmology, www.aao.org [1/1/2017: new] Additional Resources: Association of University Professors of Ophthalmology, www.aupo.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861952616 | Capital Eye Care LLC | Ophthalmology | 6720a Rockledge Dr Ste 200, Bethesda, MD 20817 | 2019-03-20 |
| 1285895508 | Osamah Jawaid Saeedi | Ophthalmology | 419 W Redwood St Ste 470, Baltimore, MD 21201 | 2008-06-19 |
| 1124021852 | Arthur L Schwartz | Ophthalmology | 5454 Wisconsin Ave, Ste 950, Chevy Chase, MD 20815-6901 | 2005-05-27 |
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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.