Deborah Green MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

241330 Issued in CO

Legal business name

DEBORAH GREEN MD PC

Practice address

315 Park Ave
Fort Lupton, CO 80621-1929

Phone

(303) 857-6111

Fax

(303) 857-2459

NPI assigned

Dec 18, 2007

Organization subpart

No

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

Authorized official

Name

Nancy Salas, MD PC

Title

Owner

Phone

(303) 857-6111

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Wynn Henman, PA-C

  • Medical Physician Assistant
  • Boulder, CO
  • NPI 1730361445
  NPD (past)
• Michelle Kaiser, N.P.

  • Family Nurse Practitioner
  • Fort Lupton, CO
  • NPI 1922340082
  NPD (past)
• Cara Spencer, N. P.

  • Family Nurse Practitioner
  • Fort Lupton, CO
  • NPI 1508298209
  NPD (past)

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1194909804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 PARK AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211929",
            "telephone_number": "303-857-6111",
            "fax_number": "303-857-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PARK AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211929",
            "telephone_number": "303-857-6111",
            "fax_number": "303-857-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH GREEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-857-6111",
        "authorized_official_credential": "MD PC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CO",
            "license": "241330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "010022980",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01241330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• County of Weld
• Krista Lynnette Cowan, LPC, LAC
• Crestline Counseling
• Avery Marie Davis
• Jaclyn A Davis, LCSW
• Theresa S Doi, PHYSCIAL THERAPIST
• Dennis Dominguez, RPH
• Sarah Eggert
• Kalina Ehrenreich-Piot, D.O.
• Scott William Entrekin

• Primary Care Clinic/Center in Fort Lupton, CO
• Providers in Fort Lupton, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.