Individual provider Active NPI

Stormy Green, D.C.

  • Chiropractor
  • Bartlett, TN
National Provider Identifier
1295513133
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3871 Issued in TN
Practice address
2690 Kirby Whitten Rd Ste 109
Bartlett, TN 38133-4742
Phone
(901) 221-7173
Fax
(662) 932-8774
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3871 TN Primary

Addresses

Primary practice location

2690 Kirby Whitten Rd Ste 109
Bartlett, TN 38133-4742

Mailing address

8101 Hacks Cross Rd Ste 110
Olive Branch, MS 38654-4032
Phone (901) 221-7173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240220002751 TX Practitioner - Chiropractic 4688018443 Reassigns benefits to 1 organization
I20241125000261 TN Practitioner - Chiropractic 4688018443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Chiro Place of Collierville PLLCGroup PAC ID 1951600428, 7 clinicians

Practice addresses (Care Compare)

3615 S Houston Levee Rd
Suite 110
Collierville, TN 38017-9173
Phone 90122171735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15751TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Chiropractic, L.L.C. CurrentSince Jan 17, 2024 Accepting new patients
The Chiro Place of Collierville PLLC Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
The Chiro Place of Douglasville PC Chiropractor CurrentSince Dec 22, 2024 Accepting new patients
The Chiro Place PLLC Chiropractor PastSince Oct 1, 2024 Accepting new patients
The Chiro Place of Midtown PLLC Chiropractor PastSince Jan 28, 2019 Accepting new patients

Locations

8101 Hacks Cross Rd
Ste 110
Olive Branch, MS 38654

2690 Kirby Whitten Rd
Ste 109
Bartlett, TN 38133
Phone (901) 217-7173

3615 S Houston Levee Rd
Ste 110
Collierville, TN 38017
Phone (901) 217-7173

3179 Poplar Ave
Memphis, TN 38111
Phone (901) 221-7173

204 Central Expy S
Ste 45
Allen, TX 75013
Phone (214) 383-9170

Organizations & group practices 5

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1295513133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 HACKS CROSS RD STE 110",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544032",
            "telephone_number": "901-221-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 KIRBY WHITTEN RD STE 109",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334742",
            "telephone_number": "901-221-7173",
            "fax_number": "662-932-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "STORMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "3871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.