Individual provider Active NPI

Mark Ellison Green, M.D.

  • Internal Medicine Physician
  • Maryville, TN
National Provider Identifier
1154395044
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000017438 Issued in TN
Practice address
365 BMH Physicians Office BLDG
Maryville, TN 37804-5820
Phone
(865) 980-5360
Fax
(865) 980-5356
NPI assigned
Feb 15, 2006
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000017438 TN Primary
Hospitalist Physician 208M00000X MD0000017438 TN

Addresses

Primary practice location

365 BMH Physicians Office BLDG
Maryville, TN 37804-5820

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other identifiers 1

IdentifierTypeStateIssuer
1526169MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041002000147 TN Practitioner - Internal MedicinePractitioner - General Practice 7113996489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

365 BMH Physicians
Office BLDG
Maryville, TN 37804-5820
Phone (865) 960-5364

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17438TNMDEmergency Medicine Physician
MD0000017438TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc Internal Medicine CurrentSince Sep 20, 2004 Accepting new patients
Maryville Pulmonary & Sleep Medicine, LLC PastSince Sep 20, 2004 Accepting new patients

Locations

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

103 W Broadway Ave
Maryville, TN 37801

1503 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 980-5290

365 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

370 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 977-4673

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

710 Morganton Square Dr
Maryville, TN 37801
Phone (865) 380-4021

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mark.green.p1@direct.bmpg.nextgenshare.com
  • Direct secure messaging: mgreen864426@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1154395044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 BMH PHYSICIANS OFFICE BLDG",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045820",
            "telephone_number": "865-980-5360",
            "fax_number": "865-980-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARK",
        "middle_name": "ELLISON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000017438",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "MD0000017438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526169",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.