Active NPI
Judy Vogt Green, R.PH.
- Pharmacist
- Ferriday, LA
National Provider Identifier
1164554721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10208
- Practice address
- 114 Louisiana Ave
Ferriday, LA 71334-2826 - Phone
- (318) 757-3811
- Fax
- (318) 757-4106
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- Sole proprietor
- No
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.
-
- Pharmacy
- Ferriday, LA
- NPI 1629069489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10208 | LA | MD | Pharmacist |
| R-05857 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Concordia Drug, Inc. | Past | Accepting new patients |
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10208 | LA | Primary |
| Pharmacist | 183500000X | R-05857 | MS |
Addresses
NPPES NPI RegistryPrimary practice location
114 Louisiana Ave
Ferriday, LA 71334-2826
Mailing address
1205 Concordia Ave
Vidalia, LA 71373-2679
Phone (318) 336-8999
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1261289 | Medicaid | LA |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164554721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 CONCORDIA AVE",
"city": "VIDALIA",
"state": "LA",
"postal_code": "713732679",
"telephone_number": "318-336-8999",
"fax_number": "318-757-4106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 LOUISIANA AVE",
"city": "FERRIDAY",
"state": "LA",
"postal_code": "713342826",
"telephone_number": "318-757-3811",
"fax_number": "318-757-4106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JUDY",
"middle_name": "VOGT",
"name_prefix": "Mrs.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "10208",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "R-05857",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1261289",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ferriday, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.