Provider Demographics
NPI:1871624627
Name:GRIENER, THAYNE C (MD)
Entity type:Individual
Prefix:
First Name:THAYNE
Middle Name:C
Last Name:GRIENER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THAYNE
Other - Middle Name:
Other - Last Name:GRIENER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-564-7118
Mailing Address - Fax:402-562-3378
Practice Address - Street 1:4508 38TH ST
Practice Address - Street 2:STE 152
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1668
Practice Address - Country:US
Practice Address - Phone:402-563-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14670207Y00000X
IN01094895A207Y00000X
MS14104207Y00000X
WI84261-20207Y00000X
NECP1682207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00114214Medicaid
WI1871624627Medicaid