NPIMap

Individual provider Active NPI

John L Green, MD

  • Diagnostic Radiology Physician
  • Albemarle, NC
National Provider Identifier
1073518700
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Practice address
301 Yadkin St
Albemarle, NC 28001-3441
Phone
(704) 984-4385
NPI assigned
Jun 17, 2005
Last updated
Nov 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NC Primary

Addresses

Primary practice location

301 Yadkin St
Albemarle, NC 28001-3441

Mailing address

PO Box 2060
Albemarle, NC 28002-2060

Other identifiers 3

IdentifierTypeStateIssuer
13804OtherNCBCBS OF NC
P00204858OtherRAILROAD MEDICARE
5900012MedicaidNC

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
I20050201000224 NC Practitioner - Diagnostic Radiology 8628028206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanly County Imaging PLLCGroup PAC ID 2567442163, 5 clinicians

Practice addresses (Care Compare)

301 Yadkin St
Albemarle, NC 28001-3441
Phone (704) 984-0990

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.83 of 100Reported as group
Quality
100
Improvement activities
40
Cost
87.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300043NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Stanly Imaging LLC CurrentSince Oct 1, 2017 Accepting new patients

Locations

103 Stanly Pkwy
Ste E
Locust, NC 28097
Phone (704) 781-0003

Organizations & group practices 2

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 10

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1073518700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2060",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280022060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013441",
            "telephone_number": "704-984-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "13804",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00204858",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900012",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

Verify at the official NPI Registry.