C Green

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0004252-C-NP Issued in CO

Practice address

323 N Crescent Dr Unit 5247
Beverly Hills, CA 90210-4883

Phone

(909) 333-6573

NPI assigned

Dec 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: carmen.green@339721039314948.direct.elationemr.com

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1043089352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N CRESCENT DR UNIT 5247",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N CRESCENT DR UNIT 5247",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104883",
            "telephone_number": "909-333-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0004252-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Tenhouten Graysen, PH.D.
• GRD Acupuncture Clinic
• Bogdan Grecea, DPM
• Anthony Greco, M.A.
• Steven Michael Greco, D.D.S.
• Leland M. Green, M.D.
• Martyn Steven Green, D.D.S.
• Jackie Greenspan
• Gregg K Nishi M D a California Profession Corporation
• Gregg K. Nishi, MD, a California Professional Corporation

• Family Nurse Practitioner in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.