Elizabeth Wallenborn Green, MA CCCLA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

671A Issued in AL

Practice address

3000 Johnson Road SW
Huntsville, AL 35805-5847

Phone

(256) 650-1701

Fax

(256) 650-1780

NPI assigned

Jun 25, 2008

Last updated

Jun 25, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama Department of Rehabilitation Services

  dba Children's Rehabilitation Services

  • Case Management Agency
  • Huntsville, AL
  • NPI 1043543838
  NPD (past)

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1407017122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 TONEY DRIVE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358021228",
            "telephone_number": "256-883-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 JOHNSON ROAD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358055847",
            "telephone_number": "256-650-1701",
            "fax_number": "256-650-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ELIZABETH",
        "middle_name": "WALLENBORN",
        "name_prefix": "Mrs.",
        "credential": "MA CCCLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "671A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christi Green, RN
• Christina R Green, CRNP
• Christopher Jason Green, MD
• David Edward Green, M.D.
• Edward Rodman Green, MD
• Evelyn Green, CRNP
• Frances Charlene Green, NP
• Jacqueline Lynn Green, MD
• Jacqueline Priscilla Green, CRNP
• Lisa H Green, NP

• Audiologist in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Audiologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.