Angela R. Green, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000510A Issued in IN

Practice address

2158 Intelliplex Dr
Suite 200
Shelbyville, IN 46176-8897

Phone

(317) 392-3651

Fax

(317) 398-0538

NPI assigned

Nov 29, 2006

Last updated

Jul 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agreen@direct.iuhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hancock Regional Hospital

  • General Acute Care Hospital
  • Greenfield, IN
  • NPI 1255418356
  Medicare reassignment NPD
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Nurse Practitioner

  Medicare reassignment NPD
• Hancock Regional Hospital

  dba Robin Run Health Center

  • Skilled Nursing Facility
  • Indianapolis, IN
  • NPI 1700291143
  NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD
• Grace Divine, LLC

  dba Grace At Home, Primary Care House Calls

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1548596372

  Nurse Practitioner

  NPD (past)
• Major Multispecialty Associates

  dba MHP Behavioral Health

  • Internal Medicine Physician
  • Shelbyville, IN
  • NPI 1437398492

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1174690713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 INTELLIPLEX DR",
            "address_2": "SUITE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768897",
            "telephone_number": "317-392-3651",
            "fax_number": "317-398-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2209 John R Wooden Dr",
            "address_purpose": "LOCATION",
            "city": "Martinsville",
            "state": "IN",
            "postal_code": "461511840",
            "country_code": "US",
            "telephone_number": "812-353-3719",
            "fax_number": "812-353-3713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ANGELA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000510",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000510A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200221890",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agreen@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2209 John R Wooden Dr",
            "city": "Martinsville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461511840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kahlil S Glenn, M.D.
• Paul Gold Jr., CAPRC I
• Goodwill Industries of Central Indiana, Inc.
• Kristina Gossett, O.T
• Grace House Ministries
• Mona G Green
• Joshua D Greene, NP
• Katherine Greene, PA
• Gregg C Mazonas DDS PC
• Angelina Alana Gregory

• Family Nurse Practitioner in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.