Blake William Green, SRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN287106 Issued in GA

Practice address

223 Lakecrest Cir SW
Calhoun, GA 30701-3564

Phone

(706) 263-9186

NPI assigned

Jan 13, 2026

Last updated

Jan 13, 2026By 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

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1245198803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 LAKECREST CIR SW",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013564",
            "telephone_number": "706-263-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 LAKECREST CIR SW",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013564",
            "telephone_number": "706-263-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BLAKE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN287106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Mia Gordon, OTRL
• Jimmie Callahan Goswick, LPC
• Amber Gravitt, NP
• Pamela M Gravitt, ACNP-BC
• Phillip Gray, M.D.
• Linda Green, MSN, CNM, FNP-C
• Diana M Gregoire
• Dane Gregory, MD
• Grins & Giggles Pediatric Dentistry
• Grins and Giggles Pediatric Dentistry

• Registered Nurse in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.