Tina Marie Green, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

VP006945B Issued in PA

Practice address

402 E Sycamore Rd
Box 398
Snow Shoe, PA 16874-8832

Phone

(814) 387-6857

Fax

(814) 387-6870

NPI assigned

Jul 20, 2005

Last updated

Sep 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Family Health Council of Central PA Inc

  • Women's Health Nurse Practitioner
  • Bellefonte, PA
  • NPI 1629329305
  NPD (past)
• Family Health Council of Central PA, Inc.

  dba CentreHuntingdon Tapestry of Health

  • Public Health or Welfare Agency
  • Bellefonte, PA
  • NPI 1891780870
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1023017050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 APPLE LN",
            "address_2": "BOX 31",
            "city": "NORTH BEND",
            "state": "PA",
            "postal_code": "177609423",
            "telephone_number": "570-923-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E SYCAMORE RD",
            "address_2": "BOX 398",
            "city": "SNOW SHOE",
            "state": "PA",
            "postal_code": "168748832",
            "telephone_number": "814-387-6857",
            "fax_number": "814-387-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP006945B",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN520073L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101182180",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX AUTH",
            "identifier": "017968",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL AANP-CERT",
            "identifier": "F1104016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia A Butler, CRNP
• Intranerve
• Keystone Rural Health Consortia Inc (Mountaintop Area Medical Center)
• Moshannon Valley Pharmacy Inc (Moshannon Valley Pharmacy)
• Nathan A Pecht, DMD
• Snow Shoe Ambulance & Rescue Service

• Nurse Practitioner in Snow Shoe, PA
• Providers in Snow Shoe, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.