Carolyn Green

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN 154793-M-IV Issued in OH

Practice address

1634 Belmar Rd
Cleveland HTS, OH 44118-1156

Phone

(216) 407-1764

NPI assigned

Jun 24, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolyn Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1083029581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 BELMAR RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181156",
            "telephone_number": "216-407-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 BELMAR RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441181156",
            "telephone_number": "216-407-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN 154793-M-IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LPN PN154793",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "GREEN",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Temima Basya Goldbaum, LPCC, ATR
• Awilda Gonzalez-Simmons
• Lydia Gooch, LPN
• Sandra Faye Graham
• Dishell Grays
• Yael Y Greenberg, PSY.D.
• Hallie B. Durchslag, LTD
• Hayer Home Health Care
• Healthspan Integrated Care
• Healthspan Integrated Care

• Licensed Practical Nurse in Cleveland HTS, OH
• Providers in Cleveland HTS, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.