Marcie Jo Greene, MSN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004841 Issued in CA

Practice address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Phone

(805) 683-1491

NPI assigned

Dec 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of California, Geffen School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vip Nephrology IncGroup PAC ID 1153429402, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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 and National Provider Directory roles.

• Vip Nephrology Inc

  • Nephrology Physician
  • Encino, CA
  • NPI 1770652554
  Medicare reassignment Care Compare group NPD
• Matthew L Bloom DO PC

  • Physical Medicine & Rehabilitation Physician
  • Ventura, CA
  • NPI 1356957047

  Family

  NPD
• 625 North a Street Oxnard Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Oxnard, CA
  • NPI 1184325144
  NPD (past)

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1205370236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 MISSION RIDGE RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032056",
            "telephone_number": "503-407-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "805-683-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16133 Ventura Blvd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914362426",
            "country_code": "US",
            "telephone_number": "818-986-6009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1280 S Victoria Ave # 250",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930036521",
            "country_code": "US",
            "telephone_number": "805-351-0745",
            "fax_number": "805-288-6744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MARCIE",
        "middle_name": "JO",
        "credential": "MSN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER NUMBER",
            "identifier": "95004841",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURNISHING NUMBER",
            "identifier": "95004841",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francis Thomas Greene, M.D.
• James Spencer Greene, MFT
• Jillian Greene, PSYD
• Jonathan Henry Greene, PH.D.
• Loretta Vernell Greene, MFTI
• Nicole Angelique Greene, M.A., CCC-A
• Robert Greene, RN
• Ryan Michael Greene, DO, MS
• Sandra Greene
• Sarah Elizabeth Creighton Greene, M.D.

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.