David Tyler Green, MA, LAT, ATC

Primary specialty

SpecialistTaxonomy code 174400000X

License

AT024 Issued in KY

Practice address

521 Lancaster Ave. Moberly 203
Eastern Kentucky University
Richmond, KY 40475

Phone

(859) 622-2140

Fax

(859) 622-8857

NPI assigned

Feb 13, 2006

Last updated

Aug 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1346213071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GENERAL NELSON DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758698",
            "telephone_number": "859-622-2140",
            "fax_number": "859-622-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 LANCASTER AVE. MOBERLY 203",
            "address_2": "EASTERN KENTUCKY UNIVERSITY",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "40475",
            "telephone_number": "859-622-2140",
            "fax_number": "859-622-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DAVID",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "MA, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "AT024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Gordon, MD
• Macy Faith Gossage
• Erin Gray, OT
• Tori Gray
• Jeffrey Tyler Gream, RN
• Nancy L Green, MIDWIFE
• Amy Leigh Gregg, APRN-BC
• Erica Louise Gregonis, MD
• Linda Fairchild Gregory, MA, CCC/SLP
• Robert Grigsby, DO

• Specialist in Richmond, KY
• Providers in Richmond, KY by specialty
• Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.