Green Clinic P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD25222 Issued in TN

Legal business name

GREEN CLINIC P.C.

Practice address

5220 Park Ave Ste 150
Memphis, TN 38119-3548

Phone

(901) 755-2255

Fax

(901) 755-9566

NPI assigned

Mar 26, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Brian Green, M.D.NPI 1700897774

Title

President/Owner

Phone

(901) 755-2255

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Brian Green, M.D.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1700897774
  Medicare reassignment NPD Authorized official
• Bridget Lashundra Hopson, NP

  • Nurse Practitioner
  • Dallas, TX
  • NPI 1477005429

  TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1306018791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193548",
            "telephone_number": "901-755-2255",
            "fax_number": "901-755-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193548",
            "telephone_number": "901-755-2255",
            "fax_number": "901-755-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "901-755-2255",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD25222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3720127",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greater Memphis Mobile Medical, LLC
• Greater Works ABA Therapy LLC
• Terry Keith Grebe, MD
• Aaron Greear, PT
• Jodie L Greear, MS, RD, LDN
• Green-White Transportation
• Amanda Green, MD
• Amy Hulsey Green, PHARM.D.
• Brian A Green, MD
• Caitlin Renae Green, PSY.D

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.