Audrey Susan Green

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2013027635 Issued in MO

Practice address

315 E Dunklin St
Jefferson City, MO 65101-3128

Phone

(573) 659-3000

NPI assigned

Sep 30, 2019

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

Practice roles

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.

• Jefferson City Public Schools

  • Local Education Agency (LEA)
  • Jefferson City, MO
  • NPI 1801019906
  NPD (past)

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1043851256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E DUNKLIN ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013128",
            "telephone_number": "573-659-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E DUNKLIN ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013128",
            "telephone_number": "573-659-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "AUDREY",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2013027635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Francis Graham, D.D.S.
• Hayley Graves, PHARMD
• Bryan Joseph Gray, BSN, RN
• Lauren Rocca Gray, MOT, OTR/L
• Kendall Lea Grayson, MA, LPC
• Chantel Marie Green, FNP
• Gladious L Green
• Natalie M Green, COTA
• Thomas Dale Greene, OD
• Thomas F Greene, O.D.

• Speech-Language Pathologist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.