Jonathan Gregory Green, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25841 Issued in SC

Practice address

1701 Skylyn Dr
Spartanburg, SC 29307-1096

Phone

(864) 393-3909

Fax

(864) 302-8433

NPI assigned

Jun 20, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• St. Luke'S Free Medical Clinic

  • Community/Behavioral Health Agency
  • Spartanburg, SC
  • NPI 1124402839
  NPD (past)

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1164153227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 AUDREY DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071500",
            "telephone_number": "864-279-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071096",
            "telephone_number": "864-393-3909",
            "fax_number": "864-302-8433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "162 N Dean St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293021517",
            "country_code": "US",
            "telephone_number": "864-542-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JONATHAN",
        "middle_name": "GREGORY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Catherine Green Flynn, LMFT
• Danetta Latia Patrice Green-McCray, MD
• Amanda S. Green, DMD
• Anastesia Green, LPC-A
• James F Green, MD
• Karen A Green
• Keisa Green, LPC
• Meghan Green, OTR/L
• Cecelia Santana Greene, NP
• Elizabeth B Greene, AGPCNP-BC

• Family Nurse Practitioner in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.