Daniel Greer, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

1821669318

Practice address

5502 Marvin Shields Blvd
BLDG 472
Gulfport, MS 39501-7000

Phone

(282) 822-5509

NPI assigned

Jul 6, 2021

Last updated

Apr 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1821669318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BRACKISH PL",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643220",
            "telephone_number": "409-998-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 MARVIN SHIELDS BLVD",
            "address_2": "BLDG 472",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395017000",
            "telephone_number": "282-822-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREER",
        "first_name": "DANIEL",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": "1821669318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Duty Corpsman in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Independent Duty Corpsman in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.