James Douglas Green, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02001778A Issued in IN

Practice address

750 N Broadway
Peru, IN 46970-1027

Phone

(765) 472-8907

NPI assigned

Nov 22, 2005

Last updated

Sep 8, 2021By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Parkview Logansport Hospital, Inc.

  dba Parkview Logansport Hospital Peru Medical Center

  • Rural Health Clinic/Center
  • Peru, IN
  • NPI 1770248015
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1841273083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701027",
            "telephone_number": "765-472-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701027",
            "telephone_number": "765-472-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "middle_name": "DOUGLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001778A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200087340",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leigh Gibbs, LCSW
• Kathleen Rae Gibson
• Joseph D Gifford, MD
• Gill Dental Holdings
• Lisa Marie Grace, BS
• Dawn Griffith, RN
• Amanda Lynn Gruss, PTA
• Meg E Guthrie-Pennington, O.D.
• Thomas J Guthrie, DDS
• Leslie Guy, MSW,LCSW

• Family Medicine Physician in Peru, IN
• Providers in Peru, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.