Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jason Kyle Green, DO

Individual provider Sleep Medicine (Internal Medicine) Physician · NPI 1164818233

Jason Kyle Green, DO is a Pulmonary Disease in Germantown, Tennessee. Graduated from West Virginia School of Osteopathic Medicine in 2015, 11 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Louisiana, Mississippi and Tennessee.

Years since qualifying
11
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
LA, MS, TN
In the registry since
2015
Specialties on file
9
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

2120 Exeter Rd Ste 250
Germantown, TN 38138-3931
Phone: (901) 767-5864
Fax: (901) 767-6591
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2647 S Saint Elizabeth Blvd Ste 215, Gonzales, LA 70737-5020 — (225) 765-5500
  • 363 Southcrest Cir Ste 201, Southaven, MS 38671-4737 — (662) 349-0488

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 4746 (TN)
Sleep Medicine (Internal Medicine) Physician Taxonomy 207RS0012X · Licence 4746 (TN)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 344135 (LA)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 30295 (MS)
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence 30295 (MS)
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence 344135 (LA)
Sleep Medicine (Internal Medicine) Physician Taxonomy 207RS0012X · Licence 30295 (MS)
Critical Care Medicine (Internal Medicine) Physician Taxonomy 207RC0200X · Licence 4746 (TN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164818233
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 15, 2015
Last updated in NPPESJanuary 30, 2026
Certification dateJanuary 30, 2026
Mailing address965 Ridge Lake Blvd Ste 315, Memphis, TN 38120-9401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPULMONARY DISEASE
Also practisesCRITICAL CARE (INTENSIVISTS)
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2015 (11 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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