Individual provider Active NPI

Melissa Green, PA-C

  • Medical Physician Assistant
  • Duncan, OK
National Provider Identifier
1013757541
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2621 N Whisenant Dr
Duncan, OK 73533-0911
Phone
(580) 252-5300
NPI assigned
May 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2621 N Whisenant Dr
Duncan, OK 73533-0911

Mailing address

2621 N Whisenant Dr
Duncan, OK 73533-0911
Phone (580) 252-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250212001643 OK Practitioner - Physician Assistant 1759811367 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority CurrentSince Mar 2, 2026 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

400 E Chestnut St
Hollis, OK 73550
Phone (580) 471-0971

Organizations & group practices 3

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1013757541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735330911",
            "telephone_number": "580-252-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735330911",
            "telephone_number": "580-252-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MELISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.