Bart Nels Green, DC, PHD

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC22689 Issued in CA

Practice address

10155 Pacific Heights Blvd
Building Az, 2ND Floor
San Diego, CA 92121

Phone

(858) 651-5918

Fax

(858) 622-1658

NPI assigned

Feb 27, 2006

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

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1386610681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 E VALLEY PKWY",
            "address_2": "#3-486",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920272322",
            "telephone_number": "858-208-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 PACIFIC HEIGHTS BLVD",
            "address_2": "BUILDING AZ, 2ND FLOOR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-651-5918",
            "fax_number": "858-622-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BART",
        "middle_name": "NELS",
        "name_prefix": "Dr.",
        "credential": "DC, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC22689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Green-Jacob, NURSE PRACTITIONER
• Acacia Marie Green
• Akia Green
• Allie Nichole Green
• Anquiette Monique Green
• Billie Green, M.D.
• Brenda Green, M.D.
• Charles Green
• Chloe T Green, PH.D.
• Crystal Elaina Green, PHD, LMFT

• Sports Physician Chiropractor in San Diego, CA
• Providers in San Diego, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.