Susanne Greene, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3004553 Issued in KY

Practice address

1111 Medical Center Cir
Mayfield, KY 42066-1194

Phone

(270) 251-4055

Fax

(270) 251-4053

NPI assigned

Jun 21, 2006

Last updated

Jan 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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 KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Purchase District Health Dept

  • Public Health or Welfare Agency
  • Paducah, KY
  • NPI 1619904836
  Medicare reassignment NPD
• Purchase District Health Dept

  • Public Health or Welfare Agency
  • La Center, KY
  • NPI 1013971720
  NPD
• Purchase District Health Dept

  • Public Health or Welfare Agency
  • Fulton, KY
  • NPI 1427000454
  NPD (past)
• Purchase District Health Dept

  • Public Health or Welfare Agency
  • Clinton, KY
  • NPI 1437186657
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1326084153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-251-4055",
            "fax_number": "270-251-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661194",
            "telephone_number": "270-251-4055",
            "fax_number": "270-251-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "SUSANNE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3004553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100042130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Graves Physician Services LLC
• Tina Renee Gray, MSCCC-SLP
• Green Acres Health Care
• Green Acres Health Services Inc (Green Acres Health Care)
• Bryan Thomas Green, PT, DPT
• Ryan O'Neil Griffith, CADCA1
• Kayce Lynne Guthrie, MHA, BSW
• Teresa Jo Hagan
• Robert F Hailey, DPM
• James Roland Hall Jr.

• Family Nurse Practitioner in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.