Jesse Nathan Greene

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

100174 Issued in GA

Practice address

1 Magnolia CT
Moultrie, GA 31768-6764

Phone

(229) 502-9753

NPI assigned

Mar 25, 2021

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 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

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cairo Medical Care, LLCGroup PAC ID 7618067042, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Home Health Services Home health agency, Thomasville, GA, CCN 117024
• Grady General Hospital Hospital, Cairo, GA, CCN 110121
• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/

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.

• Cairo Medical Care, LLC

  • Family Medicine Physician
  • Cairo, GA
  • NPI 1861572067
  Medicare reassignment Care Compare group NPD
• Grady General Hospital

  • General Acute Care Hospital
  • Cairo, GA
  • NPI 1013961507
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Grady General Hospital

  • General Acute Care Hospital
  • Cairo, GA
  • NPI 1013961507
  Care Compare affiliation
• John D Archbold Memorial Hospital Inc

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738
  Care Compare affiliation
• LHCG Ccxxii, LLC

  • Home Health Agency
  • Thomasville, GA
  • NPI 1942957600
  Care Compare affiliation

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1477130615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAGNOLIA CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAGNOLIA CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686764",
            "telephone_number": "229-502-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JESSE",
        "middle_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "100174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Wayne Graves, LCSW
• Green Oaks Center
• Green Terrace
• David Michael Green, MD
• Ava Dawn Greene, FNP-C
• Michael Brandon Griffin, PHARMD
• Sabrina Griffin, FNP-C
• Richard Lynn Griggs
• Griner Counseling, LLC
• David Griner, LCSW

• Family Medicine Physician in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.