Candace C Green, M.D.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

4301073070 Issued in MI

Practice address

2630 N Columbia Center Blvd
Suite B
Richland, WA 99352-4853

Phone

(509) 420-5053

Fax

(509) 492-5537

NPI assigned

Aug 19, 2005

Last updated

Nov 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Candace C Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Tri Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1659995504
  NPD (past)
• Tri-Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1225145105
  NPD (past)
• Carson City Center for Women's Healthcare PC

  • Obstetrics & Gynecology Physician
  • Carson City, MI
  • NPI 1396852976
  NPD (past)
• Fauster Cameron Inc.

  dba Defiance Clinic

  • Multi-Specialty Clinic/Center
  • Defiance, OH
  • NPI 1649253964
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1154313674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 N COLUMBIA CENTER BLVD",
            "address_2": "SUITE B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524853",
            "telephone_number": "509-420-5053",
            "fax_number": "509-492-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 N COLUMBIA CENTER BLVD",
            "address_2": "SUITE B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524853",
            "telephone_number": "509-420-5053",
            "fax_number": "509-492-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CANDACE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MI",
            "license": "4301073070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4706065",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4709343",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4706056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1605910202",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "0700410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "GREEN",
            "middle_name": "C",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Vanessa Lee Graves, CNA
• Jeffrey Grawe, ARNP
• Matthew Gray, ATC
• Steve Brigham Gray, CRNA
• Bradley R Green, MS, RDN, CD
• Melinda P. Greene, RNFA
• Gregory a. Oberg, P.S.
• Scott D Grewe, PH.D.
• Valerie Lynn Griffin, MA
• Douglas Edward Griffith, ARNP-C

• Obstetrics Physician in Richland, WA
• Providers in Richland, WA by specialty
• Obstetrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.