Green Lights Az LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

GREEN LIGHTS AZ LLC

Practice address

15600 N Black Canyon Hwy Ste C107
Phoenix, AZ 85053-4055

Phone

(623) 418-1234

NPI assigned

May 1, 2023

Last updated

May 5, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Racha MaytaNPI 1942882642

Title

Manager

Phone

(623) 418-1234

Specialties & licenses 1

Addresses

Locations

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.

• Racha Mayta

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1942882642
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1114615812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 N BLACK CANYON HWY STE C107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 N BLACK CANYON HWY STE C107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534055",
            "telephone_number": "623-418-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LIGHTS AZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "MAYTA",
        "authorized_official_first_name": "RACHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-418-1234"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Green MSP LLC
• Amber Stieg Green
• Arneice Melinda Green
• Brandon J Green, MD
• Brooke Kalea Green, DPT

• Non-emergency Medical Transport (VAN) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Non-emergency Medical Transport (VAN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.