Individual provider Active NPI

Mahlon Jawan Greene

  • Peer Specialist
  • Greensboro, NC
National Provider Identifier
1508713686
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
3650 McConnell Rd Apt 3H
Greensboro, NC 27405-9778
Phone
(336) 825-5391
NPI assigned
Mar 16, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X NC
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X NC Primary

Addresses

Primary practice location

3650 McConnell Rd Apt 3H
Greensboro, NC 27405-9778

Mailing address

3650 McConnell Rd Apt 3H
Greensboro, NC 27405-9778
Phone (336) 825-5391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1508713686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 MCCONNELL RD APT 3H",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274059778",
            "telephone_number": "336-825-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 MCCONNELL RD APT 3H",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274059778",
            "telephone_number": "336-825-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MAHLON",
        "middle_name": "JAWAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.