Meghan Suzanne Green, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R226548-7 Issued in MN

Practice address

111 Hundertmark Rd
#420
Chaska, MN 55318-1459

Phone

(952) 448-3847

Fax

(952) 448-5083

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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

• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345
  Medicare reassignment NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1215951751
  NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1043374259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "#100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD",
            "address_2": "#420",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181459",
            "telephone_number": "952-448-3847",
            "fax_number": "952-448-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MEGHAN",
        "middle_name": "SUZANNE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381703",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R226548-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02576878",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019381703",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "149194DL",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa J Ganske
• Rosa Marcela Garcia Soto, LICSW
• Alexandra Yared Gliadon, CNP
• Grand St Paul CVS LLC
• Shawn S. Gravelle, LPCC
• Hannah Tricia Gregg, DPT
• Jennifer Dalsveen Greseth
• Theodore Adolph Groskreutz, MD
• Grow Pelvic Health LLC
• Grows PLLC

• Pediatric Nurse Practitioner in Chaska, MN
• Providers in Chaska, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.