Dallis. Louis Green, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

N/A Issued in VA

Practice address

1531 Olde Mill Creek Dr
Suffolk, VA 23434-2320

Phone

(504) 858-6857

NPI assigned

Jun 30, 2008

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

Medicare fee-for-service enrollment

Enrolled in FL, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  VA

  Medicare reassignment NPD
• Margaret E Seymour MD PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1396282620
  Medicare reassignment

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1386806479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 W NINE MILE RD UNIT 11304",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325345373",
            "telephone_number": "850-529-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 OLDE MILL CREEK DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234342320",
            "telephone_number": "504-858-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DALLIS.",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Beginning LLC
• Greater Minds, LLC
• Greater Suffolk Medical Center
• Greater Transitions Counseling Services LLC
• Greater Visions Community Support Services, LLC.
• Kenya Green, RBT
• Kimberley B Green, MS, CCC-SLP
• Kitisha Green
• Greenbrook TMS Suffolk LLC
• Kelly Greenholtz

• Surgery Physician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.