Individual provider Active NPI

Alexis Greene

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1114437779
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0000195454 Issued in TN
Practice address
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone
(423) 302-1200
NPI assigned
Oct 9, 2017
Last updated
Oct 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0000195454 TN Primary

Addresses

Primary practice location

300 Med Tech Pkwy
Johnson City, TN 37604-2277

Mailing address

185 Settlers Way
Johnson City, TN 37615-1501

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171114001114 TN Practitioner - Nurse Practitioner 8022374735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
83.8
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000195454TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC CurrentSince Sep 11, 2017 Accepting new patients

Locations

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 323-6900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1114437779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SETTLERS WAY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376151501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MED TECH PKWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042277",
            "telephone_number": "423-302-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000195454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.