Malik Green, MSES, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2020024438 Issued in MO

Practice address

10700 Nall Ave
Overland Park, KS 66211-1206

Phone

(816) 878-0537

NPI assigned

Jul 6, 2024

Last updated

Jul 6, 2024By 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": "1720224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1265278519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 NE HENDRIX DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640863519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 NALL AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111206",
            "telephone_number": "816-878-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MALIK",
        "credential": "MSES, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2020024438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Green, LPC
• Carnell Green
• Catherine Renee Green, MSPT
• Emily Green, PHARMD
• Grace Ann Green
• Mark Darren Green, N.M.D.
• Megan Green
• Michael Green, D.C
• Michael Pieri Green, DO
• Nicolette Green, LSCSW, LCAC

• Athletic Trainer in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Athletic Trainer in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.