Waverly Syndor Green III, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

15701 Issued in NH

Practice address

580 Saint Johnsbury Rd
Suite 25
Littleton, NH 03561-3437

Phone

(603) 259-7780

Fax

(603) 444-2769

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Littleton Hospital Association

  • Critical Access Hospital
  • Littleton, NH
  • NPI 1144223702
  Medicare reassignment NPD
• Littleton Hospital Association

  • Durable Medical Equipment & Medical Supplies
  • Littleton, NH
  • NPI 1174398846
  NPD
• Littleton Hospital Association

  • Rural Health Clinic/Center
  • Littleton, NH
  • NPI 1811944523
  NPD (past)
• Harris Regional Hospital Inc

  • Pulmonary Disease Physician
  • Sylva, NC
  • NPI 1346477759
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1235123191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 SAINT JOHNSBURY RD",
            "address_2": "SUITE 25",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035613437",
            "telephone_number": "603-259-7780",
            "fax_number": "603-444-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SAINT JOHNSBURY RD",
            "address_2": "SUITE 25",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035613437",
            "telephone_number": "603-259-7780",
            "fax_number": "603-444-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WAVERLY",
        "middle_name": "SYNDOR",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "9300133",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NH",
            "license": "15701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-IND.",
            "identifier": "29211",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7937060",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Jo Goldstein, LICSW
• Jamie Gorman, WAIVER
• Callie Gould, RN
• Kathleen Govatski, C.N.M., A.R.N.P.
• Joni Marie Gray, D.C.
• Christopher Bancroft Greene, RPH
• Erica Griffin, OD
• John Scott Grisham, DDS
• Patricia A Grondin, LCMHC, MS
• Tammariah Lynn Margaret Guevin

• Pulmonary Disease Physician in Littleton, NH
• Providers in Littleton, NH by specialty
• Pulmonary Disease Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.