Individual provider Active NPI

James Mark Green, DPH

  • Pharmacist
  • Del City, OK
National Provider Identifier
1023618527
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9958 Issued in OK
Practice address
5401 Tinker Diagonal
Del City, OK 73115-4622
Phone
(405) 670-1030
Fax
(405) 670-1036
NPI assigned
Oct 26, 2020
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9958 OK Primary

Addresses

Primary practice location

5401 Tinker Diagonal
Del City, OK 73115-4622

Mailing address

5401 Tinker Diagonal
Del City, OK 73115-4622
Phone (405) 670-1030

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

LicenseStateTypeSpecialty
9958OKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1023618527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 TINKER DIAGONAL",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731154622",
            "telephone_number": "405-670-1030",
            "fax_number": "405-670-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 TINKER DIAGONAL",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731154622",
            "telephone_number": "405-670-1030",
            "fax_number": "405-670-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "middle_name": "MARK",
        "credential": "DPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "9958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.