Individual provider Active NPI

Erin L Green, APRN

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1043660194
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004748 Issued in AR
Practice address
303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120
Phone
(870) 207-7555
Fax
(870) 207-0520
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004748 AR Primary

Addresses

Primary practice location

303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120

Mailing address

303 E Matthews Ave Ste 202
Jonesboro, AR 72401-3120
Phone (870) 207-7555

Other identifiers 1

IdentifierTypeStateIssuer
218056758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20160812000355 AR Practitioner - Nurse Practitioner 7315231404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, shared by 10 NPIs, 187 clinicians

Practice addresses (Care Compare)

225 E Washington Ave
Jonesboro, AR 72401-3111
Phone (870) 972-4100

303 E Matthews Ave
202 St Bernards Senior Health Clinic
Jonesboro, AR 72401-3120
Phone (870) 207-7555

Hospital & facility affiliations

  • St Bernards Home Care Home health agency, Jonesboro, AR, CCN 047033
  • St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020
  • Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118
  • Piggott Community Hospital Hospital, Piggott, AR, CCN 041330
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A004748ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc. CurrentSince Jun 15, 2016 Accepting new patients
St Bernards Hospital Inc CurrentSince Feb 16, 2022 Accepting new patients
St. Bernards Hospital Inc CurrentSince Jun 15, 2016 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients

Locations

303 E Matthews Ave
Ste 202
Jonesboro, AR 72401
Phone (870) 207-7555

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

Interoperability endpoints

  • Direct secure messaging: elgreen@sbpc.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043660194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE STE 202",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013120",
            "telephone_number": "870-207-7555",
            "fax_number": "870-207-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E MATTHEWS AVE STE 202",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013120",
            "telephone_number": "870-207-7555",
            "fax_number": "870-207-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ERIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218056758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.