Active NPI
Jonathan Green, P.A.
- Physician Assistant
- Newburgh, IN
National Provider Identifier
1225028210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10000335A
- Practice address
- 10444 Sr 66 N
Newburgh, IN 47630-7954 - Phone
- (812) 853-9651
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10000335A | IN | Primary |
Addresses
Primary practice location
10444 Sr 66 N
Newburgh, IN 47630-7954
Mailing address
2330 Lynch Rd
Ste 250
Evansville, IN 47711-2998
Phone (812) 485-6940
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000335A | IN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1225028210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 LYNCH RD",
"address_2": "STE 250",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477112998",
"telephone_number": "812-485-6940",
"fax_number": "812-485-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10444 SR 66 N",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476307954",
"telephone_number": "812-853-9651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JONATHAN",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10000335A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.