NPIMap

Individual provider Active NPI

Elissa Clair Green, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1053873273
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08976 Issued in NC
Practice address
1313 Carolina St Ste 101
Greensboro, NC 27401-6002
Phone
(336) 235-4372
Fax
(336) 235-4381
NPI assigned
Apr 5, 2019
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08976 NC Primary

Addresses

Primary practice location

1313 Carolina St Ste 101
Greensboro, NC 27401-6002

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

Other practice location 1

1665 Westbrook Plaza Dr
Winston Salem, NC 27103-2993
Phone (336) 760-8380

Other identifiers 1

IdentifierTypeStateIssuer
0010-08976OtherNCNORTH CAROLINA MEDICAL BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egreen789441@direct.conehealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190528002628 NC Practitioner - Physician Assistant 5597008953 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-08976NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Oct 1, 2020 Accepting new patients
Wake Forest Health Network LLC CurrentSince May 13, 2019 Accepting new patients
Wake Forest Health Network, LLC CurrentSince May 13, 2019 Accepting new patients

Locations

2311 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 713-0400

1814 Westchester Dr
Ste 203
High Point, NC 27262
Phone (336) 702-1355

5826 Samet Dr
Ste 101
High Point, NC 27265
Phone (336) 878-6540

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

1188 Yadkinville Rd
Mocksville, NC 27028
Phone (336) 716-7435

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

1665 Westbrook Plaza Dr
Winston Salem, NC 27103
Phone (336) 760-8380

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: egreen2755224@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1053873273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 CAROLINA ST STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016002",
            "telephone_number": "336-235-4372",
            "fax_number": "336-235-4381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Westbrook Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271032993",
            "country_code": "US",
            "telephone_number": "336-760-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ELISSA",
        "middle_name": "CLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD",
            "identifier": "0010-08976",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egreen789441@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1313 Carolina St Ste 101",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274016002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.