MR. DALLAS ALEXANDER GREENE
NPI 1962197707
Student in an Organized Health Care Education/Training Program in Jackson, MS

Q: What is Dallas Greene's NPI number?

The NPI number for Dallas Greene is 1962197707. It was assigned to this individual provider in the NPPES registry on April 7, 2023.

Q: What is Dallas Greene's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Dallas Greene was last updated on April 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 07, 2023PECOS Enrolled

2500 N STATE ST, JACKSON, MS 39216(601) 984-5101 Get Directions Write a Review

NPPES record last updated: April 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Dallas Alexander Greene NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DALLAS ALEXANDER GREENE (NPI 1962197707) is an individual student in an organized health care education/training program in Jackson, Mississippi and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962197707

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. DALLAS ALEXANDER GREENE

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address116 Ashwood CtLeesburg, GA 31763-4415 · (229) 886-2930

Phone(601) 984-5101

Sole ProprietorNo

Enumeration DateApril 7, 2023

NPPES CertifiedApril 6, 2023

✔ NPI 1962197707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2500 N STATE ST, Jackson, MS 39216

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Dallas Alexander Greene is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)