Active NPI
Nathan Greene, PA-C
- Physician Assistant
- Jber, AK
National Provider Identifier
1073907614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2403
- Practice address
- 5800 Westover Ave
#258
Jber, AK 99506-1603 - Phone
- (907) 444-8683
- NPI assigned
- Mar 21, 2015
- Last updated
- Mar 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2403 | AK | Primary |
Addresses
Primary practice location
5800 Westover Ave
#258
Jber, AK 99506-1603
Mailing address
5800 Westover Ave
#258
Jber, AK 99506-1603
Phone (907) 444-8683
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2403 | AK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426896000000",
"number": "1073907614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 WESTOVER AVE",
"address_2": "#258",
"city": "JBER",
"state": "AK",
"postal_code": "995061603",
"telephone_number": "907-444-8683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 WESTOVER AVE",
"address_2": "#258",
"city": "JBER",
"state": "AK",
"postal_code": "995061603",
"telephone_number": "907-444-8683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "NATHAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-21",
"last_updated": "2015-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AK",
"license": "2403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jber, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.