Individual provider Active NPI

Rachel Nicole Green, APRN

  • Nurse Practitioner
  • New Albany, IN
National Provider Identifier
1417709403
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71015932A Issued in IN
Practice address
Optum
4101 Technology Ave
New Albany, IN 47150
Phone
(812) 941-4500
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28195922A IN
Nurse Practitioner 363L00000X 71015932A IN Primary

Addresses

Primary practice location

Optum
4101 Technology Ave
New Albany, IN 47150

Mailing address

6207 Kamer CT
Charlestown, IN 47111-9078
Phone (217) 493-9373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211003993 IN Practitioner - Nurse Practitioner 4486180601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Health Network of Indiana LLCGroup PAC ID 9830093533, 204 clinicians

Practice addresses (Care Compare)

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Hospital & facility affiliations

  • Baptist Health Floyd Hospital, New Albany, IN, CCN 150044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28195922AINMDRegistered Nurse
71015932AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana, LLC Nurse Practitioner CurrentSince Dec 2, 2024 Accepting new patients
American Health Network of Indiana LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

4101 Technology Ave
New Albany, IN 47150
Phone (812) 941-4500

Interoperability endpoints

  • Direct secure messaging: rgreen211696@direct.optum.com

Organizations & group practices 11

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1417709403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 KAMER CT",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119078",
            "telephone_number": "217-493-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OPTUM",
            "address_2": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "47150",
            "telephone_number": "812-941-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RACHEL",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28195922A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015932A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.