Individual provider Active NPI

Vanessa Rose Green, D.O.

  • Psychiatry Physician
  • Mansfield Center, CT
National Provider Identifier
1093036378
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
72770 Issued in CT
Practice address
189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone
(860) 456-1311
NPI assigned
Jun 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0102203122 VA
Psychiatry Physician 2084P0800X 72770 CT Primary

Addresses

Primary practice location

189 Storrs Rd
Mansfield Center, CT 06250-1683

Mailing address

189 Storrs Rd
Mansfield Center, CT 06250-1683

Other practice location 1

36000 Darnall Loop
Carl R. Darnall Army Medical Center
Fort Hood, TX 76544-5095
Phone (254) 288-8000

Other names 1

  • Dr. Vanessa Rose Morton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20221115002938 CT Practitioner - Psychiatry 6406140714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natchaug Hospital, IncGroup PAC ID 5395648737, 34 clinicians

Practice addresses (Care Compare)

189 Storrs Rd
Mansfield Center, CT 06250-1683
Phone (860) 456-1311

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72770CTMDPsychiatry Physician
0102203122VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Natchaug Hospital, Inc. CurrentSince Dec 1, 2022 Accepting new patients

Locations

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1093036378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501683",
            "telephone_number": "860-456-1311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Darnall Loop",
            "address_2": "Carl R. Darnall Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "765445095",
            "country_code": "US",
            "telephone_number": "254-288-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "VANESSA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102203122",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "72770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "MORTON",
            "middle_name": "ROSE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mansfield Center, CT

Sources for this page

Verify at the official NPI Registry.