Kelly D Green, MD - Medicare Interventional Cardiology in Jackson, TN

Kelly D Green, MD is a medicare enrolled "Internal Medicine - Cardiovascular Disease" physician in Jackson, Tennessee. He went to University Of Tennessee, Hsc, College Of Medicine and graduated in 2007 and has 17 years of diverse experience with area of expertise as Interventional Cardiology. He is a member of the group practice Jackson Clinic Pa and his current practice location is 145 Innovation Dr, Jackson, Tennessee. You can reach out to his office (for appointments etc.) via phone at (731) 422-0213.

Kelly D Green is licensed to practice in Tennessee (license number 45891) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1790909489.

Contact Information

Kelly D Green, MD
145 Innovation Dr,
Jackson, TN 38305-3019
(731) 422-0213
(731) 422-0409



Physician's Profile

Full NameKelly D Green
GenderMale
SpecialityInterventional Cardiology
Experience17 Years
Location145 Innovation Dr, Jackson, Tennessee
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kelly D Green attended and graduated from University Of Tennessee, Hsc, College Of Medicine in 2007
  NPI Data:
  • NPI Number: 1790909489
  • Provider Enumeration Date: 04/12/2007
  • Last Update Date: 10/25/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5698964500
  • Enrollment ID: I20110107000555

Medical Identifiers

Medical identifiers for Kelly D Green such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790909489NPI-NPPES
1521978MedicaidTN
P01391750OtherTNRRMC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RC0000XInternal Medicine - Cardiovascular Disease 45891 (Tennessee)Primary
207R00000XInternal Medicine 45891 (Tennessee)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Jackson-madison County General HospitalJackson, TNHospital
Baptist Memorial Hospital - Carroll CountyHuntingdon, TNHospital
Henderson County Community HospitalLexington, TNHospital
Dyersburg Regional Medical CenterDyersburg, TNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Jackson Clinic Pa2668376872176

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly D Green allows following entities to bill medicare on his behalf.
Entity NameJackson Clinic Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285629386
PECOS PAC ID: 2668376872
Enrollment ID: O20040318000962

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Entity NameVanderbilt University Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104202761
PECOS PAC ID: 5092023416
Enrollment ID: O20151006000369

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly D Green is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly D Green, MD
Po Box 400,
Jackson, TN 38302-0400

Ph: (731) 425-5752
Kelly D Green, MD
145 Innovation Dr,
Jackson, TN 38305-3019

Ph: (731) 422-0213

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Internal Medicine Doctors in Jackson, TN

John Baker, MD
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 587 Skyline Dr, Jackson, TN 38301
Phone: 731-421-6510    Fax: 731-421-6500
Dr. Susan Alex, M.D.
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 221 Sterling Farms Dr., Jackson, TN 38305
Phone: 731-668-4337    Fax: 731-661-0124
Dr. Kelsey B Dexter, M.D.
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 2863 Highway 45 Byp, Jackson, TN 38305
Phone: 731-422-0213    Fax: 731-660-8336
Kpienoba Manan Hien, M.D
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 620 Skyline Dr, Jackson, TN 38301
Phone: 731-541-5000    
Lucas Carver,
Cardiovascular Disease
Medicare: Medicare Enrolled
Practice Location: 620 Skyline Dr, Jackson, TN 38301
Phone: 731-541-5000    
Dr. Clyde E Smith, M.D.
Cardiovascular Disease
Medicare: Not Enrolled in Medicare
Practice Location: 27 Medical Center Dr, Jackson, TN 38301
Phone: 731-424-1001    
Brittain Douglas Little, M.D.
Cardiovascular Disease
Medicare: Accepting Medicare Assignments
Practice Location: 27 Medical Center Dr, Jackson, TN 38301
Phone: 731-424-1001    Fax: 731-426-0388

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