Individual provider Active NPI

Jennifer Lindsey Atwood Green, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1013458629
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP9968 Issued in AZ
Practice address
11022 S 51St St Ste 250
Phoenix, AZ 85044-4319
Phone
(480) 939-6137
Fax
(602) 429-8445
NPI assigned
Mar 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP9968 AZ Primary

Addresses

Primary practice location

11022 S 51St St Ste 250
Phoenix, AZ 85044-4319

Mailing address

44480 W Honeycutt Rd Ste 103
Maricopa, AZ 85138-2909
Phone (520) 980-9251

Other practice location 1

44480 W Honeycutt Rd Ste 103
Maricopa, AZ 85138-2909
Phone (520) 980-9251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170915000008 AZ Practitioner - Nurse Practitioner 7214201292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Mountain Family Psychiatry LLCGroup PAC ID 7012346760, 5 clinicians

Practice addresses (Care Compare)

11022 S 51St St
Suite 250
Phoenix, AZ 85044-4319
Phone (480) 939-6137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
South Mountain Family Psychiatry, LLC Psychiatric/Mental Health CurrentSince Sep 1, 2022 Accepting new patients
Enchanted Sky Family Psychiatry, PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

44480 W Honeycutt Rd
Ste 103
Maricopa, AZ 85138
Phone (520) 980-9251

11022 S 51st St
Ste 250
Phoenix, AZ 85044
Phone (480) 939-6137

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21710/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.green.1@21710.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1013458629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44480 W HONEYCUTT RD STE 103",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382909",
            "telephone_number": "520-980-9251",
            "fax_number": "520-667-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 S 51ST ST STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444319",
            "telephone_number": "480-939-6137",
            "fax_number": "602-429-8445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44480 W Honeycutt Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851382909",
            "country_code": "US",
            "telephone_number": "520-980-9251",
            "fax_number": "520-667-2397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JENNIFER",
        "middle_name": "LINDSEY ATWOOD",
        "name_prefix": "Mrs.",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP9968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.