Patrick Jermaal Greene, OTR-L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

120146 Issued in TX

Practice address

3029 Senna Dr
Matthews, NC 28105-6727

Phone

(704) 841-2115

Fax

(704) 841-2402

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1154467298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GAYOSO AVE APT 504",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032918",
            "telephone_number": "901-606-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 SENNA DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056727",
            "telephone_number": "704-841-2115",
            "fax_number": "704-841-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "PATRICK",
        "middle_name": "JERMAAL",
        "name_prefix": "Mr.",
        "credential": "OTR-L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT4021",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Marie Green, RD,LDN
• Icicess Green
• Latoya D Green
• Jacqueline Greene, PA-C
• Lisa Greene, RN, IBCLC
• Donovan Greenlee, LCSWA
• Ashley Greer, PHD, BCBA-D, LBA
• Carol Steele Grier, LPC
• Caroline Gallagher Grier, MS, LCMHCA
• Latonya Danielle Griffin, M.D.

• Occupational Therapist in Matthews, NC
• Providers in Matthews, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.