Edwin Jay Green, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20140 Issued in NC

Practice address

1317 N Elm St
Ste 2
Greensboro, NC 27401-1033

Phone

(336) 373-1676

Fax

(336) 665-6188

NPI assigned

Mar 24, 2006

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

Enrolled in NC

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.

• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064
  Medicare reassignment NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  dba Cone Health Community Pharmacy at Eden

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Certified Registered Nurse Anesthetist
  • Greensboro, NC
  • NPI 1164438578

  Internal Medicine

  NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1235199183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N ELM ST",
            "address_2": "STE 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011033",
            "telephone_number": "336-373-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N ELM ST",
            "address_2": "STE 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011033",
            "telephone_number": "336-373-1676",
            "fax_number": "336-665-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "EDWIN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "20140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936887",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Light Counseling, Inc.
• Green Valley OB/GYN
• Arthur Gerrish Green III, MD
• Charlene Edwards Green, MD
• Deborah Sue Green, NP
• Elissa Clair Green, PA-C
• Garrett Green, PA-C
• James Judd Green Jr., M.D.
• Jennifer Diane Miller Green, PHD
• Joy Anna Green, CADC

• Internal Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.