Active NPI
Penny Yvette Green, LGSW
- Social Worker
- Baltimore, MD
National Provider Identifier
1114095379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- G11093
- Practice address
- 5225 York Rd
Baltimore, MD 21212 - Phone
- (410) 467-6040
- Fax
- (410) 235-8807
- NPI assigned
- Dec 4, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | G11093 | MD | Primary |
Addresses
Primary practice location
5225 York Rd
Baltimore, MD 21212
Mailing address
2204 Maryland Avenue
Baltimore, MD 21218
Phone (410) 467-6040
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 |
|---|---|---|---|
| G11093 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Community Health Center, Inc | Past | Accepting new patients | |
| Peoples Community Health Center, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community Health Clinic/Center
- Baltimore, MD
- NPI 1083905749
-
- Federally Qualified Health Center (FQHC)
- Baltimore, MD
- NPI 1346218484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114095379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 MARYLAND AVENUE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21218",
"telephone_number": "410-467-6040",
"fax_number": "410-235-8807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 YORK RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21212",
"telephone_number": "410-467-6040",
"fax_number": "410-235-8807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "PENNY",
"middle_name": "YVETTE",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "G11093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.