Nicholas Green, BCTMB, NCTMB, HHP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

82703 Issued in CA

Practice address

1809 19TH St
Sacramento, CA 95811-6745

Phone

(916) 256-3000

NPI assigned

Jun 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1376063230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 19TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958116745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 19TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958116745",
            "telephone_number": "916-256-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "NICHOLAS",
        "credential": "BCTMB, NCTMB, HHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Kinesiotherapist",
            "state": "CA",
            "license": "803905",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "82703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanisha Renee Green
• Kayla Green
• Lakisha Green
• Marc Thomas Green Sr., CERTIFIED PEER
• Michael Thomas Green, ATC
• Norma Araceli Green
• Ralph Green, M.D.
• Rashida Green, LCSW
• Roy Albert Green III
• Scott Douglas Green, M.D.

• Massage Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.