Active NPI
Tara Rae Green, PHARM.D.
- Pharmacist
- Evansville, IN
National Provider Identifier
1194906875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26020820A
- Practice address
- 4635 1St Ave
Evansville, IN 47710-3625 - Phone
- (812) 463-0511
- Fax
- (812) 463-0516
- NPI assigned
- Nov 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26020820A | IN | Primary |
Addresses
Primary practice location
4635 1St Ave
Evansville, IN 47710-3625
Mailing address
4635 1St Ave
Evansville, IN 47710-3625
Phone (812) 463-0511
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26020820A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Houchens Express Pharmacy LLC | Past | 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.
-
- Community/Retail Pharmacy
- Huntingburg, IN
- NPI 1336450154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1194906875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 1ST AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477103625",
"telephone_number": "812-463-0511",
"fax_number": "812-463-0516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4635 1ST AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477103625",
"telephone_number": "812-463-0511",
"fax_number": "812-463-0516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TARA",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-21",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26020820A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.