Amanda B Greene, DNP, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

870536 Issued in MS

Practice address

625 S Pear Orchard Rd
Ste B
Ridgeland, MS 39157-4836

Phone

(601) 499-0282

Fax

(601) 499-0347

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ms Care Clinic, IncGroup PAC ID 7113349812, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne General Hospital Hospital, Waynesboro, MS, CCN 250077
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.greene.1@21875.direct.athenahealth.com

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.

• Ms Care Clinic, Inc

  • Clinic/Center
  • Ridgeland, MS
  • NPI 1376168500

  MS

  Medicare reassignment Care Compare group Authorized official
• Ridgeland Medical Clinic

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1053917849

  MS

  Medicare reassignment NPD
• R3 Wellness and Infusion, LLC

  • Family Nurse Practitioner
  • Gluckstadt, MS
  • NPI 1730067695
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065

  Hospital

  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527

  Hospital

  Care Compare affiliation
• Wayne General Hospital

  • General Acute Care Hospital
  • Waynesboro, MS
  • NPI 1679559983

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1083040562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S PEAR ORCHARD RD",
            "address_2": "STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574836",
            "telephone_number": "601-499-0282",
            "fax_number": "601-499-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S PEAR ORCHARD RD",
            "address_2": "STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574836",
            "telephone_number": "601-499-0282",
            "fax_number": "601-499-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "AMANDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DNP,  NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "870536",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "870536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08800015",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01627831",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latasha Grant
• Katie Allison Graves, DPT
• Cozy Gray, M.ED, NCC
• Will Gray III, DPT
• Amber Green, SLP
• Dellwyn Greene, OT
• Ashleigh H Greenhaw, OTR
• Misty D Greenwood, COTA
• Brandy Greer
• Dennis Franklin Gregory, LMFT

• All providers in Ridgeland, MS
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.

Verify at the official NPI Registry.