James Green, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10748354-1204 Issued in UT

Practice address

1322 3Rd St SE
Suite 240
Puyallup, WA 98372

Phone

(253) 697-1420

Fax

(253) 697-1439

NPI assigned

Apr 8, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Project Reality

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1134211626
  Medicare reassignment NPD

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1083000855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2493 S WILDCAT WAY UNIT B",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840108292",
            "telephone_number": "801-693-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 3RD ST SE",
            "address_2": "SUITE 240",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98372",
            "telephone_number": "253-697-1420",
            "fax_number": "253-697-1439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 3rd St SE",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723771",
            "country_code": "US",
            "telephone_number": "253-697-1420",
            "fax_number": "253-697-1439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10748354-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007238",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Anne Greb, ARNP
• Jennifer P Greco, M.A.
• Teri Ann Greco, COTA/L
• Brittany Green
• Dylan Austin Green
• Jolie Michelle Green
• Kayla L Green, PA-C
• Madison Green, PA-C
• Mary J, Phillips Green, PHD,LMHC,LMFT, LCPC
• Renae Dina Green, CCC-SLP

• Family Medicine Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.