Kevin Bernard Green

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

065153548 Issued in TN

Practice address

10217 Woodland Hills Dr
Cordova, TN 38018-6663

Phone

(901) 736-7089

NPI assigned

Mar 15, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1003319161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10217 WOODLAND HILLS DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186663",
            "telephone_number": "901-736-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10217 WOODLAND HILLS DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186663",
            "telephone_number": "901-736-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEVIN",
        "middle_name": "BERNARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TN",
            "license": "065153548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David William Gray, PTA
• Lizzie A Gray, BFA, RBT
• Shelia A Gray
• Great Strides Behavior Solutions, LLC
• Alexa Green
• Margaret Pohlman Green
• Olivia Dawn Green, COTA/L
• Toni Green
• Walter J. Green
• Thomas David Greenwell Jr., M.D.

• Non-emergency Medical Transport (VAN) in Cordova, TN
• Providers in Cordova, TN by specialty
• Non-emergency Medical Transport (VAN) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.