Individual provider Active NPI

Anita Greer

  • Nurse Practitioner
  • Kosciusko, MS
National Provider Identifier
1780087304
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R858205 Issued in MS
Practice address
308 N Jackson St
Kosciusko, MS 39090-3322
Phone
(662) 792-4101
Fax
(888) 887-7401
NPI assigned
Sep 28, 2014
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R858205 MS Primary

Addresses

Primary practice location

308 N Jackson St
Kosciusko, MS 39090-3322

Mailing address

PO Box 372
Kosciusko, MS 39090-0372
Phone (662) 792-4101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150212000310 MS Practitioner - Nurse Practitioner 3274858345 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians
MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830

1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R858205MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BMC - Attala, LLC CurrentSince Mar 28, 2016 Accepting new patients
Magnolia Medical Foundation CurrentSince Nov 12, 2020 Accepting new patients
Uppal Medical Center LLC CurrentSince Mar 11, 2026 Accepting new patients
MDB Care Management LLC PastSince Apr 6, 2023 Accepting new patients
Mallory Community Health Past Accepting new patients

Locations

1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373

215 Katherine Dr
#A
Jackson, MS 39232

220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1411862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1780087304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390900372",
            "telephone_number": "662-792-4101",
            "fax_number": "888-887-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N JACKSON ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903322",
            "telephone_number": "662-792-4101",
            "fax_number": "888-887-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREER",
        "first_name": "ANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-28",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R858205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kosciusko, MS

Sources for this page

Verify at the official NPI Registry.