Whitney Allura Green, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

66001 Issued in TN

Practice address

1St Floor Clinic Mall
2817 Rock Merritt Ave
Fort Liberty, NC 38103-3438

Phone

(910) 907-8500

NPI assigned

Apr 3, 2020

Sex

Female

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1265061162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1ST FLOOR CLINIC MALL 2817 ROCK MERRITT AVE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST FLOOR CLINIC MALL",
            "address_2": "2817 ROCK MERRITT AVE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "381033438",
            "telephone_number": "910-907-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WHITNEY",
        "middle_name": "ALLURA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "66001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Gonzalez, PHD
• Damian Graf Gatterburg
• Donna Elizabeth Gray, MD
• Erika Gray
• Kaitlin Nicole Gray, RD, CSSD, LD
• Kyle Anthony Grohmann, PH.D.
• Chelsea Lynn Gutmann, DPT
• Brady Lee Haak
• Craig Marshall Hales, LCSW, LISW-CP, DCSW
• Tyler Elliott Harris, M.D.

• General Practice Physician in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• General Practice Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.