David Taggart Green, DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PST.014380 Issued in LA

Practice address

2880 Highway 190
Mandeville, LA 70471-3254

Phone

(985) 624-8548

NPI assigned

Jul 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Bogalusa, LA
  • NPI 1619168747
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1124228283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713254",
            "telephone_number": "985-624-8548",
            "fax_number": "985-624-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713254",
            "telephone_number": "985-624-8548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 Devon Dr",
            "address_purpose": "LOCATION",
            "city": "Mandeville",
            "state": "LA",
            "postal_code": "704483407",
            "country_code": "US",
            "telephone_number": "985-778-6389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DAVID",
        "middle_name": "TAGGART",
        "name_prefix": "Mr.",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2022-12-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "14380",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.014380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1894656",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Gravley
• Denise L Gravois, OTR/L, CHT
• Gray Medical Supplies LLC
• Jarvious Grayson
• Mia Greco
• Jaleine Toinette Green, LPN
• Ryan Mark Green, ATC
• Marvin Greene
• Trudie Greene, GRADIATE SOCIAL WORK
• Amy Jo Griffin, LPN

• Pharmacist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.