Active NPI
Lisa Marie Green, MD
- Pediatrics Physician
- Kansas City, KS
National Provider Identifier
1265605513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 04-35777
- Practice address
- 4313 State Ave
Kansas City, KS 66102-3734 - Phone
- (913) 233-4400
- Fax
- (913) 287-0132
- NPI assigned
- Apr 8, 2008
- Last updated
- Feb 15, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2007013995 | MO | |
| Pediatrics Physician | 208000000X | 04-35777 | KS | Primary |
Addresses
Primary practice location
4313 State Ave
Kansas City, KS 66102-3734
Mailing address
2401 Gillham Rd
Provider Enrollment
Kansas City, MO 64108-4619
Phone (816) 701-5200
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-35777 | KS | MD | Pediatrics Physician |
| 2007013995 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Mercy-Pediatric Care North, Inc | Pediatrics | Past | Accepting new patients |
| Sibyl Downing LLC | Pediatrics | Past | Accepting new patients |
| Pediatric Urgent Care LLC | Past | Accepting new patients | |
| North Kansas City Hospital | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Kansas City, MO
- NPI 1164969952
-
dba NKC Health
- General Acute Care Hospital
- North Kansas City, MO
- NPI 1629062799
-
- Urgent Care Clinic/Center
- Saint Joseph, MO
- NPI 1497595854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455494400000",
"number": "1265605513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 GILLHAM RD",
"address_2": "PROVIDER ENROLLMENT",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641084619",
"telephone_number": "816-701-5200",
"fax_number": "816-302-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4313 STATE AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661023734",
"telephone_number": "913-233-4400",
"fax_number": "913-287-0132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2016-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2007013995",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KS",
"license": "04-35777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.