MEDICARE: ALAN S. GREENBAUM CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN123966	GA
2	367500000X	Certified Registered Nurse Anesthetist	31846	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	430067623	OTHER	GA	RAILROAD MCR - MCCG
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	344323	OTHER	GA	WELLCARE CMO - MCCG
5	000932874A	OTHER	GA	PEACHSTATE CMO - MCCG

General Provider Information

NPI Number	:	1144312984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN S. GREENBAUM CRNA

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2102
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	10/24/2022

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