Individual provider Active NPI

Michelle Gail Green, FNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1245536697
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9422087 Issued in FL
Practice address
10970 Cross Creek Blvd
Tampa, FL 33647-4055
Phone
(866) 550-2212
NPI assigned
Feb 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R121608 MD
Family Nurse Practitioner 363LF0000X APRN9422087 FL Primary

Addresses

Primary practice location

10970 Cross Creek Blvd
Tampa, FL 33647-4055

Mailing address

3210 N Andrews Avenue Ext
Pompano Beach, FL 33064-2116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224000136 FL Practitioner - Nurse Practitioner 1456538503 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9422087FLMDFamily Nurse Practitioner
R121608MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Travel Doctor, PL CurrentSince Feb 19, 2024 Accepting new patients
The Clinicians, LLC CurrentSince Dec 26, 2023 Accepting new patients

Locations

21301 Powerline Rd
Ste 106
Boca Raton, FL 33433
Phone (866) 550-2212

3210 N Andrews Avenue Ext
Pompano Beach, FL 33064

10970 Cross Creek Blvd
Ste D
Tampa, FL 33647
Phone (813) 369-5969

10970 Cross Creek Blvd
Tampa, FL 33647
Phone (813) 369-5969

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1245536697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 N ANDREWS AVENUE EXT",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330642116",
            "fax_number": "561-516-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10970 CROSS CREEK BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336474055",
            "telephone_number": "866-550-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHELLE",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R121608",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9422087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.