Individual provider Active NPI

Jennifer Lynn Greiner, D.O.

  • Otolaryngology Physician
  • Kingsport, TN
National Provider Identifier
1447469952
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
58-002215 Issued in OH
Practice address
5 Sheridan SQ
Kingsport, TN 37660-7390
Phone
(423) 146-8155
Fax
(423) 246-8658
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 58-002215 OH Primary

Addresses

Primary practice location

5 Sheridan SQ
Kingsport, TN 37660-7390

Mailing address

5 Sheridan SQ
Kingsport, TN 37660-7390
Phone (423) 146-8155

Other identifiers 1

IdentifierTypeStateIssuer
1526013MedicaidTN

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
I20111003000672 TN Practitioner - Otolaryngology 9335311927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio University, College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

105 W Stone Dr
Suite 4D
Kingsport, TN 37660-3256
Phone (423) 392-6299

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58-002215OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowview Ear Nose and Throat Spec PC CurrentSince Oct 3, 2011 Accepting new patients
Holston Medical Group PC Otolaryngology CurrentSince Nov 10, 2023 Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

322 Steeles Rd
Bristol, TN 37620
Phone (423) 217-1360

105 W Stone Dr
Ste 4D
Kingsport, TN 37660
Phone (423) 392-6299

5 Sheridan Sq
Kingsport, TN 37660
Phone (423) 246-8155

Interoperability endpoints

  • Direct secure messaging: jennifergreiner@ment.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1447469952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHERIDAN SQ",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-146-8155",
            "fax_number": "423-246-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SHERIDAN SQ",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-146-8155",
            "fax_number": "423-246-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREINER",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "58-002215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526013",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.