Active NPI
Amy Green
- Family Nurse Practitioner
- Lafayette, LA
National Provider Identifier
1104290295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN096295
- Practice address
- 4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917 - Phone
- (337) 278-9159
- NPI assigned
- Nov 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN096295 | LA | Primary |
Addresses
Primary practice location
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Mailing address
PO Box 375
Cade, LA 70519-0375
Phone (337) 278-9159
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN096295 | LA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448841600000",
"number": "1104290295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 375",
"city": "CADE",
"state": "LA",
"postal_code": "705190375",
"telephone_number": "337-278-9159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086917",
"telephone_number": "337-278-9159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "AMY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-30",
"last_updated": "2015-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "RN096295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.