Active NPI
Elisabeth Green
- Nurse Practitioner
- Edmond, OK
National Provider Identifier
1457077075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 210550
- Practice address
- 15103 N Macarthur Blvd
Edmond, OK 73013-8993 - Phone
- (405) 341-1752
- NPI assigned
- Oct 14, 2022
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 210550 | OK | Primary |
Addresses
Primary practice location
15103 N Macarthur Blvd
Edmond, OK 73013-8993
Mailing address
15103 N Macarthur Blvd
Edmond, OK 73013-8993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic Video Virtual Care, PLLC | Current | Accepting new patients |
Locations
15103 N MacArthur Blvd
Edmond, OK 73013
Phone (405) 341-1752
1520 S Bryant Ave
Edmond, OK 73013
Phone (405) 348-7980
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1457077075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15103 N MACARTHUR BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730138993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15103 N MACARTHUR BLVD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730138993",
"telephone_number": "405-341-1752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ELISABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-14",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OK",
"license": "210550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.