CHARLES C GREENE (NPI# 1306876651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306876651 |
| Entity Type | Individual |
| Full Name | CHARLES C GREENE |
| Credential | MD |
| Practice Address |
11512 Lake Mead Ave Suite 531 Jacksonville FL 32256-9680 |
| Mailing Address |
Po Box 3123 St Augustine FL 32085-3123 |
| Practice Telephone | 9044192054 |
| Practice Fax Number | 9044192057 |
| Mailing Telephone | 9044192054 |
| Mailing Fax Number | 9044192057 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-02-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | ME82871 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 264139900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215985874 | Charles William Greene Jr. | Allergy & Immunology | 534 Woods Lake Rd, Greenville, SC 29607-2778 | 2006-05-05 |
| 1427675891 | Charles Greene | Home Health | 5241 Hackney Rd, North Chesterfield, VA 23234-4597 | 2020-07-01 |
| 1275025124 | Charles Greene | Social Worker | 241 North Rd, Poughkeepsie, NY 12601-1154 | 2018-06-05 |
| 1972000909 | Charles Greene | Counselor | 417 W 3rd Ave, Albany, GA 31701-1943 | 2018-04-06 |
| 1699059923 | Charles D Greene II | Pharmacist | 16468 Highway 280, Chelsea, AL 35043-8336 | 2011-10-05 |
| 1124297130 | Charles Barrymore Greene II | Counselor | 413 S Broadway, Camden, NJ 08103-1211 | 2008-02-22 |
| 1104001221 | Charles Greene | Counselor | 1201 S Proctor St, Tacoma, WA 98405-2047 | 2008-01-08 |
| 1467501700 | Charles B Greene | Counselor | 2100 Charlie Hall Blvd, Charleston, SC 29414-5832 | 2007-01-09 |
| 1720193949 | Charles S Greene | Dentist | 811 W Wellington Ave, Dept of Dentistry - Aimmc, Chicago, IL 60657-5123 | 2006-08-20 |
| 1073554986 | Charles Henry Greene IIi | Physical Therapist | 203 S Polk St, Albany, MO 64402-1618 | 2006-06-10 |
| Street Address |
11512 LAKE MEAD AVE SUITE 531 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-9680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205831906 | Jerome O Sugar | Otolaryngology | 11512 Lake Mead Ave, Ste 531, Jacksonville, FL 32256-9680 | 2005-06-17 |
| 1952949166 | Savannah Moore | Speech-Language Pathologist | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-12-18 |
| 1225594427 | Celena Allen | Nurse Practitioner | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-02-13 |
| 1306300017 | Tara Elizabeth Strange | Speech-Language Pathologist | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-01-27 |
| 1457826810 | Annette Marie Tharp-wright | Counselor | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2018-10-11 |
| 1023515418 | Samantha J Barry | Nurse Practitioner | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2018-04-11 |
| 1073068235 | Juliann Abecassis | Acupuncturist | 11512 Lake Mead Ave, Suite 605, Jacksonville, FL 32256-9680 | 2016-08-17 |
| 1568915387 | Jacksonville Dental Specialists | Dentist | 11512 Lake Mead Ave, Ste. 532, Jacksonville, FL 32256-9680 | 2016-07-28 |
| 1972957272 | Kayla Raulerson | Behavioral Analyst | 11512 Lake Mead Ave, Suite 601, Jacksonville, FL 32256-9680 | 2016-04-22 |
| 1710331830 | Anna Beth Baden | Behavioral Analyst | 11512 Lake Mead Ave, Suite 601, Jacksonville, FL 32256-9680 | 2016-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| 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 | 32256 |
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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.