SAMUEL DOUGLAS GREESON MD NPI 1760565402

NPI Information

  • NPI: 1760565402
  • Provider Name: SAMUEL DOUGLAS GREESON, MD
  • Classification: Preventive Medicine - 2083X0100X
  • Specialization: Occupational Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7333 W JEFFERSON BLVD
    FORT WAYNE, IN
    ZIP 46804
  • Phone: (260) 458-3830

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NPI Details

Samuel Douglas Greeson, MD is an occupational medicine preventive medicine in Fort Wayne, IN. The provider is occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. Samuel Douglas Greeson, MD NPI is 1760565402. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7333 W JEFFERSON BLVD
FORT WAYNE, IN
ZIP 46804-280
Phone: (260) 458-3830
Fax: (260) 458-3831

The NPI 1760565402 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 10/24/2006 and was last updated on 3/28/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine01028597AINDIANANo
2208100000XPhysical Medicine & Rehabilitation01028597AINDIANANo
32083X0100XPreventive MedicineOccupational Medicine01028597AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000646442OTHERINDIANAANTHEM PROVIDER NUMBER
2100085750MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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