Jimmmye Dale Green Jr., OTR/L,CEAS

Primary specialty

Ergonomics Occupational TherapistTaxonomy code 225XE1200X

License

0000003798 Issued in TN

Practice address

2648 Sevierville Rd
Maryville, TN 37804-3643

Phone

(865) 984-1660

NPI assigned

Jan 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1144794348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 HIGHWAY 4 E",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386359744",
            "telephone_number": "662-544-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 SEVIERVILLE RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378043643",
            "telephone_number": "865-984-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JIMMMYE",
        "middle_name": "DALE",
        "name_suffix": "Jr.",
        "credential": "OTR/L,CEAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE1200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "TN",
            "license": "0000003798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Gravatt, PTA
• Sherri Graves, M.A., CCC-SLP
• Rebecca W Gray, CCC-SLP
• Robyn Rarick Gray, NP
• Morgan Grecu, PHARMD
• Kelsey Green, MS
• Mark Ellison Green, M.D.
• Meagan Johannah Green, M.S.
• Stephanie Michelle Green, FNP-BC
• Jonathan F Greene, D.O.

• Occupational Therapist in Maryville, TN
• Providers in Maryville, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.