Raven Victoria Green

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

2806 Dr John Haynes Dr
Pell City, AL 35125-1485

Phone

(205) 884-7621

NPI assigned

Feb 17, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15135/brand/2/csg/1/fhir/r4

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.

• Leaps Academy Inc

  • Pediatric Occupational Therapist
  • Pell City, AL
  • NPI 1336635622
  NPD (past)

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1457006512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MEADOWOOD DR",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 DR JOHN HAYNES DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351251485",
            "telephone_number": "205-884-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RAVEN",
        "middle_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2806 Dr John Haynes Dr",
            "city": "Pell City",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351251485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Channing Eden Glenn
• Grace Pain & Wellness Inc
• Alexis Grant, PA-C
• Kaley Green, CRNP
• Linda Haynie Green, M.D.
• Mallori Mays Gremmels, OTR/L
• Janet White Griebel, MA CCC-SLP
• Grove Counseling LLC
• Charlotte Alice Haley, MD
• Ariel Hall

• Occupational Therapist in Pell City, AL
• Providers in Pell City, AL by specialty
• Occupational Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.