John Green III, D.O

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

21492 Issued in MS

Practice address

6333 Highway 49
Suite 7 Achieve Medical Weight Loss
Hattiesburg, MS 39401-3132

Phone

(601) 255-5326

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGGAED/Endpoint/BGGAED

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1467491266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 GUILFORD FOREST DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303319005",
            "telephone_number": "404-691-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 HIGHWAY 49",
            "address_2": "SUITE 7 ACHIEVE MEDICAL WEIGHT LOSS",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013132",
            "telephone_number": "601-255-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "056998",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008848L",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MS",
            "license": "21492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Isaac Grayson
• Green Eye Institute PA
• Annie B Green, FNP-BC
• Cierra Celeste Green, M.D.
• Gachavis M Green, D.P.M.
• Lauren Greenspoon
• Charles E Greer, D.D.S.
• Frederick O'Neal Gregg, D.O.
• Erica Gregore
• Amanda Gregory, CMHT

• Adult Medicine Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Adult Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.