Individual provider Active NPI

Jodi K Green, DC

  • Chiropractor
  • Decatur, AL
National Provider Identifier
1164078440
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2592 Issued in AL
Practice address
2418 Danville Rd SW Ste C
Decatur, AL 35603-4278
Phone
(256) 822-2007
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2592 AL Primary

Addresses

Primary practice location

2418 Danville Rd SW Ste C
Decatur, AL 35603-4278

Mailing address

2418 Danville Rd SW Ste C
Decatur, AL 35603-4278
Phone (256) 822-2007

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL greenlifechiropractic

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020001494 AL Practitioner - Chiropractic 1153719349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2592ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Green Squared CurrentSince Sep 14, 2021 Accepting new patients

Locations

2418 Danville Rd SW
Ste C
Decatur, AL 35603
Phone (256) 822-2007

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1164078440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 DANVILLE RD SW STE C",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356034278",
            "telephone_number": "256-822-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 DANVILLE RD SW STE C",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356034278",
            "telephone_number": "256-822-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JODI",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "greenlifechiropractic",
            "affiliation": "N",
            "address_1": "2418 Danville Rd SW Ste C",
            "city": "Decatur",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356034278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.

Verify at the official NPI Registry.