Kenneth L Green, QBHP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

400 Hardin Rd Ste 150
Little Rock, AR 72211-3507

Phone

(501) 603-2147

Fax

(501) 603-0324

NPI assigned

Apr 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Arkansas Holistic Therapy

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1538794086
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1194305045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARDIN RD STE 150",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113507",
            "telephone_number": "501-603-2147",
            "fax_number": "501-603-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KENNETH",
        "middle_name": "L",
        "credential": "QBHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerriell Green
• Jerril Green, MD
• Jessica Green
• Joanna Patrice Green
• Judy Gail Green, MHPP CDA
• Lacy Green
• Lisa Marie Green, LPC
• Lyndal Green, OTR/L
• Mariyah Green
• Matthew D Green, D.O.

• Case Manager/Care Coordinator in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.