Kathy Green, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024174126 Issued in VA

Practice address

5424 Discovery Park Boulevard
BLDG. B Suite 204
Williamsburg, VA 23188

Phone

(757) 707-3508

NPI assigned

Nov 2, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
• Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
• Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment Care Compare group NPD
• Virginia Internal Medicine Inc

  • Internal Medicine Physician
  • Ashburn, VA
  • NPI 1740525245
  Medicare reassignment
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doctors' Hospital of Williamsburg

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1275893307
  Care Compare affiliation
• Mary Immaculate Hospital LLC

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1427064310
  Care Compare affiliation
• Riverside Hospital Inc

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1619938149
  Care Compare affiliation

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1295287639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064477",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5424 DISCOVERY PARK BOULEVARD",
            "address_2": "BLDG. B SUITE 204",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "23188",
            "telephone_number": "757-707-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Williamsburg Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231853779",
            "country_code": "US",
            "telephone_number": "757-565-6505",
            "fax_number": "757-565-6526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 Williamsburg Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231853779",
            "country_code": "US",
            "telephone_number": "757-565-6505",
            "fax_number": "757-565-6526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATHY",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "0024174126",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Chapter Counseling, PLLC
• Alysha M Green
• Charles William Green, NP-C
• Diane J Green, LPC
• Hannah Green
• Wanda Green, OTR
• Ronda Rochelle Greene, RN, BSN
• Nancy R Gregoire, DCSW, LCSW
• Kaylynn Greneaux
• Donna Marie Gresham, CNA

• Family Nurse Practitioner in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.
• 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.