NPIMap

Organization Active NPI

Greentree Health

  • Family Medicine Physician
  • Killeen, TX
National Provider Identifier
1316285489
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E6239 Issued in TX
Legal business name
GREENTREE HEALTH
Practice address
3106 S W S Young Dr Ste 402
Killeen, TX 76542-2015
Phone
(512) 323-6900
Fax
(512) 524-2251
NPI assigned
Jan 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Nathalie Blackstock
Title
Director, Billing
Phone
(512) 323-6900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 11534 TX
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X E6239 TX Primary

Addresses

Primary practice location

3106 S W S Young Dr Ste 402
Killeen, TX 76542-2015

Mailing address

8900 Shoal Creek Blvd Ste 300
Austin, TX 78757-6853
Phone (512) 323-6900

National Provider Directory

National Provider Directory
Tax ID family
Greentree Health11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3106 S W S Young Dr
Ste 402
Killeen, TX 76542

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1316285489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 SHOAL CREEK BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787576853",
            "telephone_number": "512-323-6900",
            "fax_number": "512-524-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 S W S YOUNG DR STE 402",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765422015",
            "telephone_number": "512-323-6900",
            "fax_number": "512-524-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENTREE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BLACKSTOCK",
        "authorized_official_first_name": "NATHALIE",
        "authorized_official_title_or_position": "DIRECTOR, BILLING",
        "authorized_official_telephone_number": "512-323-6900"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11534",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E6239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.