Individual provider Active NPI

Michael Joel Greene, DC

  • Chiropractor
  • Henderson, KY
National Provider Identifier
1265892103
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5492 Issued in KY
Practice address
490 Klutey Park Plaza Dr
Henderson, KY 42420-3348
Phone
(270) 826-1077
Fax
(270) 826-2572
NPI assigned
Mar 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5492 KY Primary

Addresses

Primary practice location

490 Klutey Park Plaza Dr
Henderson, KY 42420-3348

Mailing address

PO Box 1646
Henderson, KY 42419-1646
Phone (270) 826-1077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330001888 KY Practitioner - Chiropractic 2961709373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Tinius Chiropractic Center, PLLCGroup PAC ID 9133213234, 2 clinicians

Practice addresses (Care Compare)

1300 Tamarack Rd
Owensboro, KY 42301-6965
Phone (270) 926-8042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5492KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tinius Chiropractic Center, PLLC Chiropractor CurrentSince May 26, 2022 Accepting new patients

Locations

1300 Tamarack Rd
Owensboro, KY 42301
Phone (270) 926-8042

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": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1265892103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1646",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424191646",
            "telephone_number": "270-826-1077",
            "fax_number": "270-826-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 KLUTEY PARK PLAZA DR",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203348",
            "telephone_number": "270-826-1077",
            "fax_number": "270-826-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MICHAEL",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.