Organization Active NPI

Michael E. Green

  • Ophthalmology Physician
  • Gallatin, TN
National Provider Identifier
1104025246
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD0000025545 Issued in TN
Legal business name
MICHAEL E. GREEN
Practice address
854 Lone Oak Dr
Gallatin, TN 37066-3694
Phone
(615) 452-1602
Fax
(615) 451-0139
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Authorized official

Name
Amy Burton
Title
Director
Phone
(434) 661-7762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD0000025545 TN Primary

Addresses

Primary practice location

854 Lone Oak Dr
Gallatin, TN 37066-3694

Mailing address

854 Lone Oak Dr
Gallatin, TN 37066-3694
Phone (615) 452-1602

Other identifiers 10

IdentifierTypeStateIssuer
2680132003OtherTNCIGNA COMMERCIAL
3083540OtherTNMEDICARE PROVIDER ID - IN
NASH86608OtherTNPHCS
0840119OtherTNUNITED HEALTH CARE
4480107OtherTNAETNA
3373178OtherTNMEDICARE PROVIDER ID- GRO
F88358OtherTNUPIN
180019007OtherTNMEDICARE RAILROAD
3373178MedicaidTN
0191345OtherTNBLUE CROSS BLUE SHIELD OF

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060509000596 TN Part B Supplier - Clinic/Group Practice 4082625769 Receives reassigned benefits from 2 practitioners
Practice locations: Gallatin, TN

National Provider Directory

National Provider Directory

Locations

854 Lone Oak Dr
Ste 120
Gallatin, TN 37066
Phone (615) 452-1602

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1104025246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 LONE OAK DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663694",
            "telephone_number": "615-452-1602",
            "fax_number": "615-451-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 LONE OAK DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663694",
            "telephone_number": "615-452-1602",
            "fax_number": "615-451-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. GREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "434-661-7762"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD0000025545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA COMMERCIAL",
            "identifier": "2680132003",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID - IN",
            "identifier": "3083540",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "NASH86608",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0840119",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4480107",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID- GRO",
            "identifier": "3373178",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F88358",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "180019007",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3373178",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "0191345",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.