Organization Active NPI

Greystone Medical Clinic, P.C.

  • Acute Care Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1770519530
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN10467 Issued in TN
Legal business name
GREYSTONE MEDICAL CLINIC, P.C.
Practice address
1044 Greystone Square
Jackson, TN 38305
Phone
(731) 661-1031
Fax
(731) 664-5496
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Marcus Antonio Desio, M.D.
Title
Owner
Phone
(731) 661-1031

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X TN0000030429 TN
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X TN0000030429 TN
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X APN10467 TN Primary

Addresses

Primary practice location

1044 Greystone Square
Jackson, TN 38305

Mailing address

1044 Greystone Square
Jackson, TN 38305
Phone (731) 661-1031

National Provider Directory

National Provider Directory

Locations

1044 Greystone Sq
Jackson, TN 38305
Phone (731) 661-0131

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1770519530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 GREYSTONE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-1031",
            "fax_number": "731-664-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 GREYSTONE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-1031",
            "fax_number": "731-664-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREYSTONE MEDICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DESIO",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-661-1031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "TN0000030429",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "TN0000030429",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN10467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.