Todd Richard Green, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

6299 Issued in AK

Practice address

2351 Canary CT
Anchorage, AK 99515-1402

Phone

(907) 243-4677

Fax

(907) 243-4676

NPI assigned

Apr 24, 2007

Last updated

Dec 12, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1215156948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8543 GOLDEN ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995025241",
            "telephone_number": "907-347-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 CANARY CT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151402",
            "telephone_number": "907-243-4677",
            "fax_number": "907-243-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TODD",
        "middle_name": "RICHARD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "6299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD5636",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kilei Green
• Kristine Kay Green
• Megan Green
• Michael D Green, MD, PHD
• Rosa Green
• Georgiann Greenan
• Kevin Greenan
• Jay Greene
• Louis Greene, PT
• Mary Catherine Greene, M.S., CCC-SLP

• Internal Medicine Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Internal Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.