Active NPI
Sydney Desira Greene, DPT
- Physical Therapist
- Mountain Home, AR
National Provider Identifier
1386276293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3278
- Practice address
- 300 Good Samaritan Dr
Mountain Home, AR 72653-5813 - Phone
- (870) 425-2494
- NPI assigned
- Feb 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3278 | AR | Primary |
Addresses
Primary practice location
300 Good Samaritan Dr
Mountain Home, AR 72653-5813
Mailing address
305 Marshall St
Flippin, AR 72634-8085
Phone (870) 405-2144
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT3278 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581120000000",
"number": "1386276293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 MARSHALL ST",
"city": "FLIPPIN",
"state": "AR",
"postal_code": "726348085",
"telephone_number": "870-405-2144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 GOOD SAMARITAN DR",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726535813",
"telephone_number": "870-425-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "SYDNEY",
"middle_name": "DESIRA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-08",
"last_updated": "2020-02-08",
"certification_date": "2020-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT3278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.