Carrie L Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07000 Issued in NC

Practice address

403 Fairview St
Clinton, NC 28328-2399

Phone

(910) 592-6011

NPI assigned

Jan 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinton Medical Clinic, Inc.Group PAC ID 6406821628, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sampson Regional Medical Center Hospital, Clinton, NC, CCN 340024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: carriegreen@cmci.allscriptsdirect.net
• Direct secure messaging: clintonmedicalclinic@cmci.allscriptsdirect.net

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.

• Clinton Medical Clinic, Inc.

  • General Practice Physician
  • Clinton, NC
  • NPI 1780629154
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sampson Regional Medical Center

  • General Acute Care Hospital
  • Clinton, NC
  • NPI 1609857432
  Care Compare affiliation

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1164969614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011",
            "fax_number": "910-592-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Fairview St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "NC",
            "postal_code": "283282312",
            "country_code": "US",
            "telephone_number": "910-592-6011",
            "fax_number": "910-592-0811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARRIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clintonmedicalclinic@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "403 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carriegreen@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "403 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Goshen Medical Center Incorporated
• Goshen Medical Center, Inc
• Goshen Medical Center, Inc.
• Leah Elizabeth Graves, PA-C
• Graybar-Clinton, Inc
• Claudia Green
• Felicia Green
• Gridiron 24-7
• Savannah Griffin, DO
• Grigoriy Grigoryan, CRNA

• Physician Assistant in Clinton, NC
• Providers in Clinton, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.