Inpatient Pediatric Services

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

INPATIENT PEDIATRIC SERVICES

Practice address

3421 Medical Park Dr
Monroe, LA 71203-2355

Phone

(318) 387-3453

Fax

(318) 323-9045

NPI assigned

Jul 1, 2006

Last updated

Jul 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mitra Green, M.D.NPI 1699702761

Title

Physician

Phone

(318) 387-3453

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mitra Marie Green, M.D.

  • Pediatrics Physician
  • Monroe, LA
  • NPI 1699702761
  Authorized official Same address or phone

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1407885791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 LAMY LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013735",
            "telephone_number": "318-387-3453",
            "fax_number": "318-323-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 MEDICAL PARK DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032355",
            "telephone_number": "318-387-3453",
            "fax_number": "318-323-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INPATIENT PEDIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MITRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-387-3453",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449725",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.