Individual provider Active NPI

Kathy J. Green, M.D., M.P.H.

  • Family Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1053464065
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71593 Issued in AZ
Practice address
51 Brian Mickelsen Pkwy
Cottonwood, AZ 86326-3610
Phone
(928) 639-8132
NPI assigned
Jan 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 71593 AZ Primary

Addresses

Primary practice location

51 Brian Mickelsen Pkwy
Cottonwood, AZ 86326-3610

Mailing address

1090 Commerce Dr
Prescott, AZ 86305-3700
Phone (928) 583-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630003477 AZ Practitioner - Family Practice 1850516527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of YavapaiGroup PAC ID 8921919499, 20 clinicians

Practice addresses (Care Compare)

1090 Commerce Dr
Prescott, AZ 86305-3700
Phone (928) 583-1000

51 S Brian Mickelsen Pkwy
Cottonwood, AZ 86326-3610
Phone (928) 639-8132

Hospital & facility affiliations

  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Yavapai CurrentSince May 13, 2025 Accepting new patients
County of Yavapai CurrentSince May 13, 2025 Accepting new patients
County of Yavapai Current Accepting new patients
County of Yavapai Current Accepting new patients

Locations

51 Brian Mickelsen Pkwy
Cottonwood, AZ 86326
Phone (928) 639-8132

1090 Commerce Dr
Prescott, AZ 86305
Phone (928) 583-1000

Interoperability endpoints

  • Direct secure messaging: kathy.green.p1@direct.ycchs.nextgenshare.com

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 2

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": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1053464065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700",
            "telephone_number": "928-583-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BRIAN MICKELSEN PKWY",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263610",
            "telephone_number": "928-639-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "71593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.