James Edward Green, AA, PA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

263 Issued in MI

Practice address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493

Phone

(616) 364-4200

Fax

(616) 364-7347

NPI assigned

Aug 16, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts, Physician Assistant

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 and National Provider Directory roles.

• Anesthesia Medical Consultants, PC

  • Anesthesiology Physician
  • Grand Rapids, MI
  • NPI 1063710689
  Medicare reassignment NPD
• West Michigan Anesthesia, PC

  • Anesthesiology Physician
  • Grand Rapids, MI
  • NPI 1225016926
  Medicare reassignment
• Emergency Care Specialists PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1093766958
  NPD (past)
• Spectrum Health Hospitals

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1598712390
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1285747378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "AA, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001816",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": "263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00343185",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M73860-008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1598712390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Elizabeth Green, OTR/L
• Ethan Thomas Green
• Hannah Susanne Green
• Jacques Dewayne Green, LMSW
• Jamelia Green
• Joy Marie Green
• Katie M Green, MSW
• Kelly Alaine Green, LMSW
• Kendall Leigh Green, LLMSW
• Kristen Green

• Anesthesiologist Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Anesthesiologist Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.