Roderick Green, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R828349 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 815-5815

Fax

(601) 984-5842

NPI assigned

Apr 3, 2013

Last updated

Jul 29, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Precise Clinical Neuroscience SpecialistsGroup PAC ID 4880737626, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Central Hospital, Jackson, MS, CCN 250072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Precise Clinical Neuroscience Specialists

  dba Right Track Medical Group

  • Psychiatry Physician
  • Flowood, MS
  • NPI 1770717449
  Medicare reassignment Care Compare group NPD
• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  dba Pine Belt Mental Health Care Resources

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Region XII Commission

  • General Practice Physician
  • Laurel, MS
  • NPI 1467767988
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• Precise Psychopharmacology LLC

  • Psychiatry Physician
  • Flowood, MS
  • NPI 1407053051
  NPD (past)

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

• Jackson Hma LLC

  dba Merit Health Central

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1033163092
  Care Compare affiliation

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1235472697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5815",
            "fax_number": "601-984-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-5815",
            "fax_number": "601-984-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RODERICK",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R828349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09282029",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flora K. Green, AGPCNP
• Jennifer Green
• Jennifer Green, BCBS
• John Franklin Green, M.D.
• Kiarra Green, CTRS
• Virginia Little Green, M.D.
• Dallas Alexander Greene
• Leilani Lani Greening, PHD
• Christopher Edmund Greenleaf, M.D., M.B.A.
• Prisca Evelyn Greenwood, M.A

• Psychiatric/Mental Health Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.