Active NPI
Aileen L Green, MD, PHD
- Nuclear Medicine Physician
- Saint Louis, MO
National Provider Identifier
1083832075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Physician
- License
- 2021042469
- Practice address
- 915 N Grand Blvd
Saint Louis, MO 63106-1621 - Phone
- (314) 652-4100
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician | 207U00000X | 53800-20 | WI | |
| Nuclear Medicine Physician | 207U00000X | 2021042469 | MO | Primary |
Addresses
Primary practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Mailing address
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100
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
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021042469 | MO | MD | Nuclear Medicine Physician |
| 53800-20 | WI | MD | Nuclear Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1083832075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 N GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631061621",
"telephone_number": "314-652-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 N GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631061621",
"telephone_number": "314-652-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "AILEEN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "WI",
"license": "53800-20",
"primary": false
},
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "MO",
"license": "2021042469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.