Active NPI
Green Angel Healthcare Consulting, Inc.
- Family Nurse Practitioner
- Austell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- GREEN ANGEL HEALTHCARE CONSULTING, INC.
- Practice address
- 4760 Austell Rd, Suite #3
Austell, GA 30106-4007 - Phone
- (404) 452-2519
- Fax
- (678) 252-6427
- NPI assigned
- Aug 8, 2015
- Last updated
- Dec 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angella Dinina Green, FNP
- Title
- Owner
- Phone
- (404) 452-2519
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 186231 | GA | |
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
4760 Austell Rd, Suite #3
Austell, GA 30106-4007
Mailing address
4760 Austell Rd, Suite 3
Austell, GA 30106-4007
Phone (404) 452-2519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2300942 | Green Angel Healthcare Consulting | Certificate of waiver | Mar 18, 2028 |
National Provider Directory
National Provider DirectoryLocations
4760 Austell Rd
Ste 3
Austell, GA 30106
Phone (678) 442-8525
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1702857600000",
"number": "1114303567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4760 AUSTELL RD, SUITE 3",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301064007",
"telephone_number": "404-452-2519",
"fax_number": "678-252-6427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 AUSTELL RD, SUITE #3",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301064007",
"telephone_number": "404-452-2519",
"fax_number": "678-252-6427"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN ANGEL HEALTHCARE CONSULTING, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-08",
"last_updated": "2023-12-18",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "ANGELLA",
"authorized_official_middle_name": "DININA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "404-452-2519",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "GA",
"license": "186231",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.