Active NPI
Jennifer Green
- Home Health Registered Nurse
- Penn Yan, NY
National Provider Identifier
1235537408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 543075-1
- Practice address
- 417 Liberty St Ste 2120
Penn Yan, NY 14527-1124 - Phone
- (315) 531-3448
- NPI assigned
- Dec 19, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 543075-1 | NY | Primary |
Addresses
Primary practice location
417 Liberty St Ste 2120
Penn Yan, NY 14527-1124
Mailing address
417 Liberty St Ste 2120
Penn Yan, NY 14527-1124
Phone (315) 531-3448
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 543075-1 | NY | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418947200000",
"number": "1235537408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 LIBERTY ST STE 2120",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271124",
"telephone_number": "315-531-3448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 LIBERTY ST STE 2120",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271124",
"telephone_number": "315-531-3448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-19",
"last_updated": "2014-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "NY",
"license": "543075-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penn Yan, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.