Active NPI
Lizina Blessing Green, MD
- Family Medicine Physician
- Charleston, SC
National Provider Identifier
1033438189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34145
- Practice address
- 109 Bee St
Charleston, SC 29401-5703 - Phone
- (843) 577-5011
- NPI assigned
- May 27, 2010
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34145 | SC | Primary |
Addresses
Primary practice location
109 Bee St
Charleston, SC 29401-5703
Mailing address
3381 Phillis Blvd
Myrtle Beach, SC 29577-1560
Phone (843) 457-0177
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34145 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1033438189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3381 PHILLIS BLVD",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295771560",
"telephone_number": "843-457-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-577-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "LIZINA",
"middle_name": "BLESSING",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-27",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "34145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.