Active NPI
Paula Marie Green, LMSW
- Social Worker
- Idaho Falls, ID
National Provider Identifier
1023527181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-37036
- Practice address
- 2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902 - Phone
- (208) 524-7400
- NPI assigned
- Sep 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-37036 | ID | Primary |
Addresses
Primary practice location
2275 W Broadway St Ste G
Idaho Falls, ID 83402-2902
Mailing address
26 N 3167 E
Idaho Falls, ID 83402-5663
Phone (208) 360-3344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 412032666 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-37036 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505952000000",
"number": "1023527181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 N 3167 E",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834025663",
"telephone_number": "208-360-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 W BROADWAY ST STE G",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834022902",
"telephone_number": "208-524-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "PAULA",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-21",
"last_updated": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-37036",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "412032666",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.