Active NPI
Kristen Green, MS CCC-SLP
- Speech-Language Pathologist
- Roanoke Rapids, NC
National Provider Identifier
1104128057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9007
- Practice address
- 512 Arbutus Dr E
Roanoke Rapids, NC 27870-2272 - Phone
- (252) 717-7924
- Fax
- (252) 824-0660
- NPI assigned
- Nov 29, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9007 | NC | Primary |
Addresses
Primary practice location
512 Arbutus Dr E
Roanoke Rapids, NC 27870-2272
Mailing address
PO Box 248
Hobgood, NC 27843-0248
Phone (252) 717-7924
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9007 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1104128057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 248",
"city": "HOBGOOD",
"state": "NC",
"postal_code": "278430248",
"telephone_number": "252-717-7924",
"fax_number": "252-824-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 ARBUTUS DR E",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278702272",
"telephone_number": "252-717-7924",
"fax_number": "252-824-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KRISTEN",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "9007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.