P Praxis·MD
● Active Type 1 · Individual

Tyson Darrell Greener, PA-C

Physician Assistant·Burley, ID· NPI 1356123863 · Enumerated 2023 · 2 years on NPI
Greener is 1 of 1 physician assistant providers in Burley and 1 of 97 in Idaho.
NPI age
2 years
Enumerated 2023-10-18
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-02-07
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 97 active physician assistant providers in Idaho.

NPI age
2 years
↓ 11 yr below median (13 yr)
State licenses
1 state
23% of peers hold multiple states
Subspecialties
1
In the 56% of peers with subspecialties

NPI lifetime · 2023 → 2026

2023-10Enumerated in NPPES
2023 2026

Where they practice

Practice location
260 E 5th St N
Burley, ID 833183453
📞 2086789760fax 2086789758
Mailing address
684 E 400 N
Rupert, ID 833509460
📞 2086707008

Additional practice locations

1 secondary location on file with NPPES.

Location 2
1224 8th St
Rupert, ID 833501599
📞 2084360481fax 2084366038

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #6571244 taxonomy 363AS0400X
  • Physician Assistant
    A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
    taxonomy 363A00000X

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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