Randy Green

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

410 S Franklin St
Bastrop, LA 71220

Phone

(318) 410-1062

NPI assigned

Jul 12, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Body & Soul Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bastrop, LA
  • NPI 1285193185
  NPD (past)

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1053763102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S FRANKLIN ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "71220",
            "telephone_number": "318-410-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RANDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Shepherd Personal Care LLC
• Good Shepherd Personal Care Service LLC
• Shannon L Grantham, LCSW
• Janika E Gray, PT, DPT
• Curt Green
• Sheila C Green, LPC
• Trenton Lamar Green, MA
• Shamijah Griffin
• Tyler Guice, LPTA
• Janos G Guoth, M.D.

• Case Manager/Care Coordinator in Bastrop, LA
• Providers in Bastrop, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.