DR. GERRY BOWEN GREEN (NPI# 1184792160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184792160 |
| Entity Type | Individual |
| Full Name | DR. GERRY BOWEN GREEN |
| Credential | DMD |
| Practice Address |
144 S Thomas St Tupelo MS 38801-5312 |
| Mailing Address |
Po Box 2363 Tupelo MS 38803-2363 |
| Practice Telephone | 6628404422 |
| Mailing Telephone | 6628404422 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2014-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 5885 | AL | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
3373-06 | MS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05973097 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528326527 | Gerry Green | Counselor | 550 River Rd, Eugene, OR 97404-3212 | 2012-04-26 |
| Street Address |
144 S THOMAS ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942248208 | Joseph Morris Alexander | Psychologist | 144 S Thomas St, Ste 104a, Tupelo, MS 38801-5312 | 2006-06-02 |
| 1356749709 | Joy Johnson Counseling | Counselor | 144 S Thomas St, Ste 104a, Tupelo, MS 38801-5312 | 2014-12-17 |
| 1972924033 | Brian Thomas, Psy.d. Pllc | Clinical Neuropsychologist | 144 S Thomas St, Ste 103 Room 1, Tupelo, MS 38801-5312 | 2013-12-16 |
| 1538419718 | Gilbert's Hospice Care, LLC | Hospice Care, Community Based | 144 S Thomas St, Suite 105, Tupelo, MS 38801-5337 | 2012-09-14 |
| 1619178100 | Ms Pmr & Pmc, Pllc | Physical Medicine & Rehabilitation | 144 S Thomas St, Building 1, Suite 101-2, Tupelo, MS 38801-5312 | 2007-05-30 |
| 1598883266 | Bruce Edward Porter | Physical Medicine & Rehabilitation | 144 S Thomas St, Building Number 1 Suite 101-2, Tupelo, MS 38801-5312 | 2007-03-27 |
| 1295845832 | Susan Fretwell Garner | Nurse Practitioner | 144 S Thomas St, Tupelo, MS 38801-5312 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205057585 | Harry Thomas Cosby | Dentist | 144 South Thomas Street, Suite 203, Tupelo, MS 38801 | 2007-05-02 |
| 1528258464 | Ks2 Ms PC | Dentist | 401 S Gloster St, Suite 101, Tupelo, MS 38801-5539 | 2007-07-26 |
| 1346209194 | Brent Johnson Crumpton | Dentist | 210 E Main St, Ste 2e, Tupelo, MS 38804-4031 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619145539 | Kristy Goff Jones | Dentist | 301 Northlake Ave Ste 111, Ridgeland, MS 39157-1720 | 2008-02-13 |
| 1235349143 | Richard Ted Rice | Dentist | 910 Bechtel Blvd, Ocean Springs, MS 39564-3057 | 2007-05-23 |
| 1699981183 | Mark Wayne Moore | Dentist | 2301 12th St, Meridian, MS 39301-3934 | 2007-05-14 |
| 1619005972 | Endodontic Associates, Pllc | Dentist | 301 Northlake Ave, Suite 111, Ridgeland, MS 39157-1718 | 2007-03-01 |
| 1891822474 | James Derek White | Dentist | 1 Woodgreen Pl, Suite 100, Madison, MS 39110-8161 | 2007-02-28 |
| 1962566646 | J Thad Strange | Dentist | 517 Keywood Cir Ste 1a, Flowood, MS 39232-3054 | 2006-12-20 |
| 1346335064 | Ronald S. Bourgeois | Dentist | 423 Security Sq, Gulfport, MS 39507-1922 | 2006-10-04 |
| 1811098999 | Thomas Ferris Gerrets Jr. | Dentist | 599 Steed Rd # A, Ridgeland, MS 39157-1707 | 2006-09-25 |
| 1134238322 | Lance D Dillon | Dentist | 927 Highway 51, Madison, MS 39110 | 2006-08-30 |
| 1457465304 | Floyd Norman Ford | Dentist | 2900 Bluecutt Rd, Suite 4, Columbus, MS 39705-1470 | 2006-08-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.