Philip David Green, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

23705 Issued in NC

Practice address

1040 Medical Park Ave
New Bern, NC 28562-5248

Phone

(252) 633-1678

Fax

(252) 633-1403

NPI assigned

Sep 1, 2005

Last updated

Sep 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1003800335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12248",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612248",
            "telephone_number": "252-514-6685",
            "fax_number": "252-514-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MEDICAL PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625248",
            "telephone_number": "252-633-1678",
            "fax_number": "252-633-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "PHILIP",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "23705",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "23705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1036C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891036C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Wensing Graziosi, L.P.A.
• Great Place to Start Behavioral Health Services
• Lynette Leigh Greathouse, RN
• Katherine S Green, ACNP-AG
• Kayla Quinnae Green
• Tammy L Green, MA/CCC-SLP
• Carroll H Greene III, PHD
• Sharon S Greenwald, M.ED., MSW, LCSW
• Mary Greyard, DPT
• Ormond Drew Grice, M.D.

• Emergency Medicine Physician in New Bern, NC
• Providers in New Bern, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.