Active NPI
Ryan Green, PH.D.
- Clinical Neuropsychologist
National Provider Identifier
1174886667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 2084
- Practice address
- Landstuhl Regional Medical Center Unit 33100
Apo, AE 09180-3100
DE - Phone
- (314) 590-7887
- NPI assigned
- Jun 19, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 2084 | AL | Primary |
Addresses
Primary practice location
Landstuhl Regional Medical Center Unit 33100
Apo, AE 09180-3100
DE
Mailing address
Landstuhl Regional Medical Center Unit 33100
Apo, AE 09180-3100
DE
Other practice location 1
301 Andrews Ave
Fort Rucker, AL 36362-5333
Phone (801) 261-7193
Other practice location 2
9040A Fitzsimmons Dr
Tacoma, WA 98431-0001
Phone (253) 968-2700
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2084 | AL | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aerospace Neuropsychology Services | Clinical Neuropsychologist | Current | Accepting new patients |
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.
-
- Clinical Neuropsychologist
- Layton, UT
- NPI 1013884766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174886667",
"addresses": [
{
"country_code": "DE",
"country_name": "Germany",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100",
"city": "APO",
"state": "AE",
"postal_code": "091803100"
},
{
"country_code": "DE",
"country_name": "Germany",
"address_purpose": "LOCATION",
"address_type": "FGN",
"address_1": "LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100",
"city": "APO",
"state": "AE",
"postal_code": "091803100",
"telephone_number": "314-590-7887"
}
],
"practiceLocations": [
{
"address_1": "301 Andrews Ave",
"address_purpose": "LOCATION",
"city": "Fort Rucker",
"state": "AL",
"postal_code": "363625333",
"country_code": "US",
"telephone_number": "801-261-7193",
"fax_number": "334-255-7710",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9040A Fitzsimmons Dr",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984310001",
"country_code": "US",
"telephone_number": "253-968-2700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "RYAN",
"name_prefix": "Mr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-19",
"last_updated": "2022-07-21",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AL",
"license": "2084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.