Active NPI
Jodi K Green, DC
- Chiropractor
- Decatur, AL
National Provider Identifier
1164078440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2592
- 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
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 |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | greenlifechiropractic |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2592 | AL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Squared | Current | 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.
-
- Health Service Clinic/Center
- Decatur, AL
- NPI 1679116230
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.