Provider Demographics
NPI:1922208610
Name:MCGREEVY, KAI (MD)
Entity Type:Individual
Prefix:DR
First Name:KAI
Middle Name:
Last Name:MCGREEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 W TWINCOURT TRL
Mailing Address - Street 2:SUITE 607
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095-8805
Mailing Address - Country:US
Mailing Address - Phone:904-230-3006
Mailing Address - Fax:
Practice Address - Street 1:559 W TWINCOURT TRL
Practice Address - Street 2:SUITE 607
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32095-8805
Practice Address - Country:US
Practice Address - Phone:904-230-3006
Practice Address - Fax:877-638-8891
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1090282084N0400X, 2084P0301X, 2084P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury Medicine
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014758300Medicaid
GA003132774EMedicaid
GA003132774BMedicaid
GA003132774AMedicaid
GA003116541CMedicaid
GA003132774DMedicaid
GA202I723649Medicare PIN
GA003132774DMedicaid
GA003116541CMedicaid