Michael Stephen Green, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

9882 Issued in MN

Practice address

4570 Churchill St
Suite 300
Shoreview, MN 55126-2273

Phone

(651) 451-1071

Fax

(651) 481-0042

NPI assigned

Jun 4, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1427461748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR",
            "address_2": "SUITE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224840",
            "telephone_number": "952-512-5600",
            "fax_number": "952-512-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 CHURCHILL ST",
            "address_2": "SUITE 300",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551262273",
            "telephone_number": "651-451-1071",
            "fax_number": "651-481-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P14894",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "5941",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "9882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golf Transportation LLC
• Bradley Denver Goodell Jr., PSY.D.
• Lori Jean Grambow, RN
• Grand St Paul CVS LLC (Target Pharmacy)
• Thomas Michael Graske, MA LP CSAT
• Dale Ellen Grossman, PH.D.
• Kristeen Laura Groth, OTR
• Madison Gruenewald, MA, LADC
• Jeanette Lorraine Guillaume Marshall, PH.D
• Heather Gunderson, LICSW

• Orthopedic Physical Therapist in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Orthopedic Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.