Brandon Green, DO

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

074287 Issued in GA

Practice address

410 N State of Franklin Rd
Suite 130
Johnson City, TN 37604-6971

Phone

(423) 431-2477

NPI assigned

Oct 1, 2009

Last updated

Sep 23, 2016By 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 2

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 Osteopathy

State licenses

Practice roles

Locations

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.

• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  dba BHMA Interventional Radiology - Johnson City

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1043688385
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Cardiovascular Disease Physician
  • Johnson City, TN
  • NPI 1740227131
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1275867715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SANCTUARY CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154191",
            "telephone_number": "423-444-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 130",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046971",
            "telephone_number": "423-431-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-01",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "GA",
            "license": "074287",
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TN",
            "license": "DO2176",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Macy Carrier Gray
• Steven L Gray, PSY.D.
• Graybeal Orthopedic, LLC (Anchor Brace and Limb)
• Heather Danielle Greear, NP
• Angel Miguel Green, DO
• Carla L Green, APN
• James Green
• Jessica Beth Green
• Kathie Ann Green, CMSW
• Lisa W Green, CRNA

• Pediatric Orthopaedic Surgery Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Pediatric Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.