Georgina Green
Individual provider Active NPI Family Medicine Physician · Kansas City, MO
NPI 1114309358 · NPPES record last updated Jun 24, 2015
Key facts
- NPI
- 1114309358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2015020155 (MO)
- Practice address
- 6675 Holmes Rd Ste 450
Kansas City, MO 64131-1173 - Phone
- (816) 276-7650
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Miami County Medical Center Inc
Practice addresses (Care Compare)
2100 Baptiste Dr
Paola, KS 66071-1314
Phone (913) 294-2327
Hospital & facility affiliations
- Faith Home Healthcare, Inc
- Angels Care Home Health
- Interim Healthcare of Kansas City
- Miami County Medical Center
- University of Kansas Health System Olathe Hospital
- University of Kansas Hospital
- The Healthcare Resort of Olathe
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181107002227 | KS | Practitioner - Family Practice | 6002102340 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015020155 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miami County Medical Center Inc. | Family Medicine | Current |
Accepting new patients |
| Miami County Medical Center Inc. | Current |
Accepting new patients | |
| Miami County Medical Center Inc | Current | Accepting new patients | |
| Goppert - Trinity Family Care, LLC | Family Medicine | Past | Accepting new patients |
Locations
1318 Kansas Dr
Paola, KS 66071
Phone (913) 557-5678
2100 Baptiste Dr
Paola, KS 66071
Phone (913) 294-2327
Interoperability endpoints
- ggreen183394@direct.kuha.org
- georgina.green@hca2.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2015020155 | MO | Yes |
Addresses
Primary practice location
6675 Holmes Rd Ste 450
Kansas City, MO 64131-1173
Mailing address
14805 Hadley St
Overland Park, KS 66223-2772
Phone (913) 403-6036
Other providers in Kansas City, MO
- Green Lakes Village Home Care LLC
- Green Ring LLC
- Ashelyn Nehcole Green
- Beena Green
- Elizabeth R Green
- Harry Green
- Jamie Green
- Jeff Green
- Jehnna Green
- Laura Elizabeth Green
All providers in Kansas City, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.