Individual provider Active NPI

Jason Richard Greenlee, D.O.

  • Urology Physician
  • Salisbury, NC
National Provider Identifier
1548610967
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2021-02014 Issued in NC
Practice address
911 W Henderson St Ste 110
Salisbury, NC 28144-2700
Phone
(704) 633-9441
Fax
(704) 637-9006
NPI assigned
Jun 16, 2016
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 5101022671 MI
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X 2021-02014 NC Primary

Addresses

Primary practice location

911 W Henderson St Ste 110
Salisbury, NC 28144-2700

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone (248) 967-7795 ext. 6

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgreenlee887152@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210805003486 NC Practitioner - Urology 2264728963 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Stone Center PLLCGroup PAC ID 2961315718, 71 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1907 S Hawthorne Rd
Winston Salem, NC 27103-3916
Phone (336) 765-6373

911 W Henderson St
Suite 120
Salisbury, NC 28144-2700
Phone (704) 637-9006

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022671MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Caldwell Memorial Hospital, Inc Multi-Specialty Current Accepting new patients
Caldwell Memorial Hospital, Inc. Multi-Specialty CurrentSince Dec 30, 2021 Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Piedmont Stone Center PLLC Multi-Specialty CurrentSince Dec 1, 2021 Accepting new patients
Caldwell Memorial Hospital Inc. Multi-Specialty CurrentSince Dec 30, 2021 Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty Current Accepting new patients
Novant Health Medical Group, LLC Multi-Specialty Past Accepting new patients

Locations

401 Mulberry St SW
Ste 210
Lenoir, NC 28645
Phone (828) 757-5517

911 W Henderson St
Ste 110
Salisbury, NC 28144
Phone (704) 633-9441

911 W Henderson St
Ste 120
Salisbury, NC 28144
Phone (704) 637-1779

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1907 S Hawthorne Rd
Winston Salem, NC 27103

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jgreenlee887152@direct.novanthealth.org
  • Direct secure messaging: jgreenlee795039@direct.unc.nchie.net

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1548610967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W HENDERSON ST STE 110",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442700",
            "telephone_number": "704-633-9441",
            "fax_number": "704-637-9006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27351 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480713487",
            "country_code": "US",
            "telephone_number": "248-967-7795 x6",
            "fax_number": "248-967-7794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "JASON",
        "middle_name": "RICHARD",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101022671",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NC",
            "license": "2021-02014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgreenlee887152@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "911 W Henderson St Ste 110",
            "city": "Salisbury",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281442700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.