Randall Devin Green Jr., FNP-C, RN, AE-C, CPN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024194196 Issued in VA

Practice address

2001 Colonial Ave SW
Roanoke, VA 24015-3210

Phone

(866) 389-2727

NPI assigned

Feb 11, 2025

Last updated

Jan 26, 2026By 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 1

Addresses

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, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Virginia LLCGroup PAC ID 6709960891, 142 clinicians

Minuteclinic Primary Care - Virginia PLLCGroup PAC ID 7012425085, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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.

• Minuteclinic Diagnostic of Virginia LLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1417076829
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care - Virginia PLLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1275341620
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1295540821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COLONIAL AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153210",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COLONIAL AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240153210",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RANDALL",
        "middle_name": "DEVIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP-C, RN, AE-C, CPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-11",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024194196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwight Greathouse, APRN-CRNA
• Stephanie A Greathouse, FAMILY NP
• Bonnie Green
• Michael John-Edward Green
• Ranasia Green
• Tiffany Green
• Mark Greenawald, MD
• Grant M Greenberg, MD, MA
• Sally Sarah Greenberg
• Greenbrook TMS Roanoke

• Family Nurse Practitioner in Roanoke, VA
• Providers in Roanoke, 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 Jan 26, 2026; 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.