NPIMap

Individual provider Active NPI

Johnny Richard Green Jr., DO

  • Internal Medicine Physician
  • Oxford, MS
National Provider Identifier
1851979983
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33279 Issued in MS
Practice address
81 Ed Perry Blvd Ste 107
Oxford, MS 38655-3465
Phone
(662) 636-5290
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T-4329 TN
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 33279 MS Primary

Addresses

Primary practice location

81 Ed Perry Blvd Ste 107
Oxford, MS 38655-3465

Mailing address

965 Ridge Lake Blvd
Memphis, TN 38120-9401
Phone (901) 227-4692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815002994 MS Practitioner - Internal Medicine 2567853823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

81 Ed Perry Blvd
Suite 107
Oxford, MS 38655-3465
Phone (662) 636-6290

Hospital & facility affiliations

  • Baptist Home Care and Hospice North Mississippi Home health agency, Batesville, MS, CCN 257114
  • Baptist Home Care & Hospice-North Mississippi Hospice, Batesville, MS, CCN 251523
  • Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-4329TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Feb 18, 2025 Accepting new patients
Baptist Memorial Medical Group Inc Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
Baptist Memorial Hospital North Mississippi, Inc Past Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

81 Ed Perry Blvd
Ste 107
Oxford, MS 38655
Phone (662) 636-5290

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

965 Ridge Lake Blvd
Memphis, TN 38120

Interoperability endpoints

  • Direct secure messaging: jgreen638490@direct.bmhcc.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1851979983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "901-227-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 ED PERRY BLVD STE 107",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553465",
            "telephone_number": "662-636-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHNNY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "T-4329",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "33279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.