Individual provider Active NPI

Jason Kyle Greenhagen, D.O.

  • Psychiatry Physician
  • Madison, AL
National Provider Identifier
1639582877
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
3712 Issued in TN
Practice address
600 Sun Temple Dr
Madison, AL 35758-8643
Phone
(256) 325-2627
NPI assigned
Jun 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1989 AL
Psychiatry Physician 2084P0800X 3712 TN Primary

Addresses

Primary practice location

600 Sun Temple Dr
Madison, AL 35758-8643

Mailing address

3841 Green Hills Village Dr
Nashville, TN 37215-2691

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
I20190801002725 TN Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 3678831740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

3601 The Vanderbilt Clinic
Nashville, TN 37232-5100
Phone (615) 322-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3712TNMDClinical Neuropsychologist
1989ALMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Psychiatry CurrentSince Oct 15, 2022 Accepting new patients
Vanderbilt University Medical Center Past Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

1301 Medical Center Dr
Nashville, TN 37232
Phone (615) 343-4882

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

3841 Green Hills Village Dr
Nashville, TN 37215
Phone (615) 322-7127

1265 E College St
Pulaski, TN 38478
Phone (931) 363-7531

Interoperability endpoints

  • Direct secure messaging: jgreenhagen738774@direct.vumc.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1639582877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357588643",
            "telephone_number": "256-325-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENHAGEN",
        "first_name": "JASON",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "1989",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "3712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.