Mitchell Wayne Green, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08002727A Issued in IN

Practice address

706 Ridge Rd
Munster, IN 46321-1612

Phone

(219) 836-8890

NPI assigned

Sep 25, 2013

Last updated

Sep 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carlson Chiropractic CorporationGroup PAC ID 0749366821, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carlson Chiropractic Corporation

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1982888020
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1174959977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211612",
            "telephone_number": "219-836-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211612",
            "telephone_number": "219-836-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MITCHELL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002727A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012402",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Graham, NP
• Cassondra Grahovac, FNP-C
• Sandra J Grano-Vrbanoff, LCSW
• Great Lakes Surgical Suites, LLC (Great Lakes Surgical Suites)
• Alecia Green, FNP-BC
• Sierra N Green, PMHNP-BC
• Catherine Elizabeth Gregori
• Tyler Gress, DC
• Mark Allen Grevious, M.D.
• Griffin Broadmoor Pharmacy Inc (Broadmoor Pharmacy)

• Chiropractor in Munster, IN
• Providers in Munster, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.