Active NPI
Karen A Green, PHARMACIST
- Pharmacist
- Tyler, TX
National Provider Identifier
1417557158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28472
- Practice address
- 6801 S Broadway Ave
Tyler, TX 75703-4733 - Phone
- (903) 581-4842
- Fax
- (903) 939-8937
- NPI assigned
- Oct 30, 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28472 | TX | Primary |
Addresses
Primary practice location
6801 S Broadway Ave
Tyler, TX 75703-4733
Mailing address
6801 S Broadway Ave
Tyler, TX 75703-4733
Phone (903) 581-4842
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 |
|---|---|---|---|
| 28472 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1417557158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 S BROADWAY AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757034733",
"telephone_number": "903-581-4842",
"fax_number": "903-939-8937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6801 S BROADWAY AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757034733",
"telephone_number": "903-581-4842",
"fax_number": "903-939-8937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KAREN",
"middle_name": "A",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-30",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "28472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.