NPIMap

Organization Active NPI

Greenwood Leflore Hospital

Doing business as Greenwood Neurology Clinic

  • Neurology Physician
  • Greenwood, MS
National Provider Identifier
1083674204
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
GREENWOOD LEFLORE HOSPITAL
Doing business as
Greenwood Neurology Clinic
Practice address
1317 River Rd
Greenwood, MS 38930
Phone
(662) 459-2520
NPI assigned
Mar 23, 2006
Last updated
Jul 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Authorized official

Name
Dawne Holmes
Title
Cfo
Phone
(662) 459-7119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

1317 River Rd
Greenwood, MS 38930

Mailing address

PO Box 1410
Greenwood, MS 38935-1410
Phone (662) 459-2520

Other names 1

  • Greenwood Neurology Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080728000452 MS Part B Supplier - Clinic/Group Practice 7517031313 Receives reassigned benefits from 2 practitioners
Practice locations: Greenwood, MS

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1317 River Rd
Greenwood, MS 38930
Phone (662) 459-2520

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1083674204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-459-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "38930",
            "telephone_number": "662-459-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD LEFLORE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "DAWNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "662-459-7119"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenwood Neurology Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greenwood Neurology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.