Individual provider Active NPI

Jordan Hugart Greer II, DO

  • Emergency Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1861856023
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12108A Issued in WY
Practice address
214 E 23Rd St
Cheyenne, WY 82001-3748
Phone
(307) 432-3118
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 12108A WY Primary

Addresses

Primary practice location

214 E 23Rd St
Cheyenne, WY 82001-3748

Mailing address

214 E 23Rd St
Cheyenne, WY 82001-3748
Phone (307) 432-3118

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190612001893 WY Practitioner - Emergency Medicine 4183968175 Reassigns benefits to 2 organizations
I20211122000998 OK Practitioner - Emergency Medicine 4183968175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group LLCGroup PAC ID 5092094532, 39 clinicians

Practice addresses (Care Compare)

214 E 23Rd St
Cheyenne, WY 82001-3748
Phone (307) 634-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12108AWYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, LLC Emergency Medicine CurrentSince May 1, 2019 Accepting new patients
Emergency Physicians of Midwest City, LLC Emergency Medicine CurrentSince Oct 18, 2021 Accepting new patients
Ivinson Memorial Hospital CurrentSince Dec 7, 2019 Accepting new patients
Ivinson Memorial Hospital CurrentSince Dec 7, 2019 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

100 N 30th St
Clinton, OK 73601
Phone (580) 323-2363

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

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 1

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1861856023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E 23RD ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013748",
            "telephone_number": "307-432-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 23RD ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013748",
            "telephone_number": "307-432-3118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083607059",
            "country_code": "US",
            "telephone_number": "856-641-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREER",
        "first_name": "JORDAN",
        "middle_name": "HUGART",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "12108A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.