Michael Greene, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15159 Issued in MS

Practice address

935 Highway 51
Madison, MS 39110-8407

Phone

(601) 856-5986

Fax

(601) 853-2321

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of North Texas HSC, College of Osteopathic Med, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quad Intermed Company LLCGroup PAC ID 6709245954, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgreene2546096@direct.casso.us.com

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.

• Quad Intermed Company LLC

  • Clinic/Center
  • Laurel, MS
  • NPI 1952099913
  Medicare reassignment Care Compare group NPD
• Quad Intermed Company LLC

  • Clinic/Center
  • Vicksburg, MS
  • NPI 1205524261
  NPD
• Quad Intermed Company LLC

  dba MEA Medical Clinics

  • Clinic/Center
  • Pearl, MS
  • NPI 1205619483
  NPD
• First Intermed Corporation

  dba MEA Medical Clinics

  • Family Medicine Physician
  • Clinton, MS
  • NPI 1376577379
  NPD (past)
• First Intermed Corporation

  dba MEA Medical Clinics

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1932133931
  NPD (past)
• Quad Intermed Company LLC

  • Clinic/Center
  • Yazoo City, MS
  • NPI 1093403065
  NPD (past)

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

• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417964081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 HIGHWAY 51",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108407",
            "telephone_number": "601-856-5986",
            "fax_number": "601-853-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 HIGHWAY 51",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391108407",
            "telephone_number": "601-856-5986",
            "fax_number": "601-853-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "15159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117668",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane R Goff, RN
• Olivia Ross Goff, LPC
• Traci Goodwin, RD
• Breckin Skye Gray, FNP
• David Green, M.D.
• Stephen Charles Greer II DMD, D.M.D
• Claire Dornbusch Griner, D.M.D.
• Heatherly Henson Grissom, D.M.D.
• Jason Scott Grissom, D.M.D.
• Lindsey Morgan Groce

• Family Medicine Physician in Madison, MS
• Providers in Madison, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.