Active NPI
Kendall Bryce Green, M.D.
- Occupational Medicine Physician
- Albuquerque, NM
National Provider Identifier
1235467358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- MD2009-0674
- Practice address
- 2400 Tucker
Family Practice Center RM 232
Albuquerque, NM 87131-0001 - Phone
- (505) 272-8043
- Fax
- (505) 272-8044
- NPI assigned
- Dec 1, 2009
- Last updated
- Dec 1, 2009
- 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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | MD2009-0674 | NM | Primary |
Addresses
Primary practice location
2400 Tucker
Family Practice Center RM 232
Albuquerque, NM 87131-0001
Mailing address
2400 Tucker
Family Practice Center RM 232
Albuquerque, NM 87131-0001
Phone (505) 272-8043
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2009-0674 | NM | MD | Occupational Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unm Medical Group Inc | Past | Accepting new patients | |
| Unm Hospital | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1689747552
-
dba Center for Development & Disability
- Developmental Disabilities Clinic/Center
- Albuquerque, NM
- NPI 1851614432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259625600000",
"number": "1235467358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 TUCKER",
"address_2": "FAMILY PRACTICE CENTER RM 232",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-8043",
"fax_number": "505-272-8044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 TUCKER",
"address_2": "FAMILY PRACTICE CENTER RM 232",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-8043",
"fax_number": "505-272-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KENDALL",
"middle_name": "BRYCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-01",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NM",
"license": "MD2009-0674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.