Individual provider Active NPI

Alicia Marie Green, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Durham, NC
National Provider Identifier
1396344578
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
42210 Issued in SC
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-0411
NPI assigned
Oct 20, 2020
Last updated
May 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42210 SC
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 42210 SC Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

509 N Mangum St Apt 408
Durham, NC 27701-4928
Phone (843) 754-8240

Other practice location 1

701 Grove Rd
Greenville, SC 29605-4210
Phone (843) 754-8240

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
42210SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1396344578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N MANGUM ST APT 408",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277014928",
            "telephone_number": "843-754-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "843-754-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "42210",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "42210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.