Eric L Green, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA23651 Issued in FL

Practice address

257 SW Dade St
Madison, FL 32340-2361

Phone

(850) 973-3316

Fax

(850) 973-1261

NPI assigned

Nov 6, 2012

Last updated

Nov 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tallahassee Orthopedic & Sports Physical Therapy

  • Physical Therapist
  • Madison, FL
  • NPI 1104956341
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1235483793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD",
            "address_2": "SUITE 300",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088405",
            "telephone_number": "850-877-8855",
            "fax_number": "859-877-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 SW DADE ST",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323402361",
            "telephone_number": "850-973-3316",
            "fax_number": "850-973-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ERIC",
        "middle_name": "L",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Gilbert
• Alexis Nicole Goins, RDH
• Golden Health of Florida LLC (Golden Health of Florida)
• Kattrina Gonzalez, LMFT
• Gracey & Mercy Medical Transport LLC
• Thomas Harvey Greene III, P.A.-C.
• Hawk Health Systems LLC (Madison Life Spring Clinic)
• Shirley Haynes
• Helping Hands of North Florida Services LLC
• Joseph Murray Herring, D.C.

• Physical Therapy Assistant in Madison, FL
• Providers in Madison, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.