Active NPI
Cierra Celeste Green, M.D.
- Family Medicine Physician
- Hattiesburg, MS
National Provider Identifier
1063709525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 23976
- Practice address
- 66 Old Airport Rd
Hattiesburg, MS 39401 - Phone
- (601) 544-7500
- Fax
- (601) 544-7524
- NPI assigned
- Jul 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 23976 | MS | Primary |
| Family Medicine Physician | 207Q00000X | 4301098722 | MI |
Addresses
Primary practice location
66 Old Airport Rd
Hattiesburg, MS 39401
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700
Other practice location 1
180 W S F Tatum Blvd
Hattiesburg, MS 39401
Phone (601) 450-0805
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04774531 | Medicaid | MS | |
| 12684749 | Other | MS | CAQH |
Other names 1
- Cierra Celeste Colbert
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1721 Medical Park Dr
Biloxi, MS 39532-2109
Phone (228) 207-0601
Hospital & facility affiliations
- Mississippi Homecare of Picayune
- Enhabit Home Health of the Gulf Coast
- Ochsner Medical Center-Hancock
- Ochsner Medical Center Acute
- Memorial Hospital at Gulfport
- Singing River Gulfport
- Singing River Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23976 | MS | MD | Family Medicine Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Bay Saint Louis, MS
- NPI 1538674239
Hospital & facility affiliations 67
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Gulfport, MS
- NPI 1013142066
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554681600000",
"number": "1063709525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394031729",
"telephone_number": "601-545-8700",
"fax_number": "601-450-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 OLD AIRPORT RD",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "39401",
"telephone_number": "601-544-7500",
"fax_number": "601-544-7524"
}
],
"practiceLocations": [
{
"address_1": "180 W S F Tatum Blvd",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "39401",
"country_code": "US",
"telephone_number": "601-450-0805",
"fax_number": "601-450-0806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "CIERRA",
"middle_name": "CELESTE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2019-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "23976",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301098722",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04774531",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12684749",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CIERRA",
"last_name": "COLBERT",
"middle_name": "CELESTE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.