Individual provider Active NPI

Ronald D Green, RN

  • Community Health Registered Nurse
  • Sevierville, TN
National Provider Identifier
1053661090
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN0000190352 Issued in TN
Practice address
709 Middle Creek Rd
Sevierville, TN 37862-5047
Phone
(865) 453-1032
Fax
(865) 429-2689
NPI assigned
Sep 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN0000190352 TN Primary

Addresses

Primary practice location

709 Middle Creek Rd
Sevierville, TN 37862-5047

Mailing address

709 Middle Creek Rd
Sevierville, TN 37862-5047
Phone (865) 453-1032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000190352TNMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1053661090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625047",
            "telephone_number": "865-453-1032",
            "fax_number": "865-429-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625047",
            "telephone_number": "865-453-1032",
            "fax_number": "865-429-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RONALD",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "RN0000190352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.