Active NPI
Melissa Green, CRNA
- Certified Registered Nurse Anesthetist
- Lakeside, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN156511
- Practice address
- 5080 Mogollon Rim Dr
Lakeside, AZ 85929-5530 - Phone
- (480) 297-5926
- NPI assigned
- Jun 29, 2006
- Last updated
- Nov 2, 2011
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN156511 | AZ | Primary |
Addresses
Primary practice location
5080 Mogollon Rim Dr
Lakeside, AZ 85929-5530
Mailing address
5080 Mogollon Rim Dr
Lakeside, AZ 85929-5530
Phone (480) 297-5926
Other names 1
- Melissa Kemper
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN156511 | AZ | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeastern Anesthesia PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Northern Indiana Anesthesia Services, P.C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Anesthesia Associates of Savannah ,PA | Past | Accepting new patients | |
| Southern Girl Anesthesia Services Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375
5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Sierra Vista, AZ
- NPI 1487956504
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Show Low, AZ
- NPI 1548409451
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Savannah, GA
- NPI 1487663688
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1083639660
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1144258989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 MOGOLLON RIM DR",
"city": "LAKESIDE",
"state": "AZ",
"postal_code": "859295530",
"telephone_number": "480-297-5926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5080 MOGOLLON RIM DR",
"city": "LAKESIDE",
"state": "AZ",
"postal_code": "859295530",
"telephone_number": "480-297-5926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MELISSA",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "RN156511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "KEMPER",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lakeside, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.