Katrina Green, M.D.
Individual provider Active NPI Emergency Medicine Physician · Nashville, TN
NPI 1063673622 · NPPES record last updated Sep 8, 2011
Key facts
- NPI
- 1063673622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD0000047159 (TN)
- Practice address
- 3441 Dickerson Pike
Nashville, TN 37207-2539 - Phone
- (615) 769-4401
- Fax
- (615) 769-4730
- NPI assigned
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Wayne State University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeastern Emergency Physicians LLC
Practice addresses (Care Compare)
1818 Albion St
Nashville, TN 37208-2918
Phone (615) 341-4000
Hospital & facility affiliations
- Metro Nashville General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110615000525 | TN | Practitioner - Emergency Medicine | 9931386166 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01066950A | IN | MD | Emergency Medicine Physician |
| MD0000047159 | TN | MD | Emergency Medicine Physician |
| 11014308A | IN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Hospital Authority | Current |
Accepting new patients | |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Coverage, LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Physicians of Montgomery County, PLLC | Emergency Medicine | Past | Accepting new patients |
| Emergency Coverage Services, PC | Past | Accepting new patients |
Locations
651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000
9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
4007 Clarksville Pike
Ste 200
Nashville, TN 37218
Phone (615) 341-4968
1818 Albion St
Nashville, TN 37208
Phone (615) 341-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01066950A | IN | |
| Emergency Medicine Physician | 207P00000X | MD0000047159 | TN | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | 11014308A | IN |
Addresses
Primary practice location
3441 Dickerson Pike
Nashville, TN 37207-2539
Mailing address
2020 21St Ave S
Suite 201
Nashville, TN 37212-4354
Phone (615) 269-0652
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1523695 | Medicaid | TN |
Other providers in Nashville, TN
- Jennifer Robin Green
- Jonathan Edward Green
- Jonathan Presley Green
- Julia C. Green
- Kaneisha Green
- Lindsay Green
- Lisa M Green
- Lynnissa Green
- Makayla Green
- Margaret Green
All providers in Nashville, TN · Emergency Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.