Active NPI
Nyisha O Green, CNA, CMA
- Technician
- Racine, WI
National Provider Identifier
1376966390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- H5K8N2B6
- Practice address
- 1177 Reiley CT
Racine, WI 53403-1759 - Phone
- (260) 308-2961
- Fax
- (262) 260-8433
- NPI assigned
- Jan 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | H5K8N2B6 | GA | Primary |
Addresses
Primary practice location
1177 Reiley CT
Racine, WI 53403-1759
Mailing address
1177 Reiley CT
Racine, WI 53403-1759
Phone (262) 308-2961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Medical Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H5K8N2B6 | GA | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390780800000",
"number": "1376966390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 REILEY CT",
"city": "RACINE",
"state": "WI",
"postal_code": "534031759",
"telephone_number": "262-308-2961",
"fax_number": "262-260-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 REILEY CT",
"city": "RACINE",
"state": "WI",
"postal_code": "534031759",
"telephone_number": "260-308-2961",
"fax_number": "262-260-8433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "NYISHA",
"middle_name": "O",
"credential": "CNA, CMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-27",
"last_updated": "2014-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "GA",
"license": "H5K8N2B6",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.