Shavaughn R Green, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

53087 Issued in TN

Practice address

1310 24TH Ave S
Nashville, TN 37212-2637

Phone

(615) 873-7547

NPI assigned

Apr 13, 2012

Last updated

Apr 12, 2016By the provider in NPPES

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

Other names 1

• Shavaughn R Green-Felix Other name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1457618563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 24TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122637",
            "telephone_number": "615-873-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHAVAUGHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "53087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAVAUGHN",
            "last_name": "GREEN-FELIX",
            "middle_name": "R",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Jeffrey Green, M.D.
• Ronya Green, M.D.
• Ruie Tyler Green, RNC
• Sarah Green, MD
• Sharon Fetterman Green, M.D.
• Sheba L Green
• Taylor Green
• Thedaus Green
• Travis Lee Green, PA
• William Spalding Green IV, D.M.D.

• Internal Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.

Verify at the official NPI Registry.