Evelyn L Green, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A130258 Issued in TX

Practice address

818 N 4TH St
Longview, TX 75601-5433

Phone

(903) 236-8600

Fax

(903) 236-8605

NPI assigned

Feb 22, 2016

Sex

Female

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

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.

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1386003036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015433",
            "telephone_number": "903-236-8600",
            "fax_number": "903-236-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015433",
            "telephone_number": "903-236-8600",
            "fax_number": "903-236-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "EVELYN",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "A130258",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "A130258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Deann Gray
• Miranda Lynn Gray, MSN, APRN, FNP-C
• Mitchell G Grayson, LCDC
• Monica J Grayson, LCDC
• Greater Hospice of Texas, Inc.
• Haley Green, M.A. CCC-SLP
• Juanita Bell Green
• Kelly Robert Green, M.S.
• Tricia G. Green, APN
• Savannah Greene

• Family Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.