Courtney Green

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0007676 Issued in MD

Practice address

1130 Annapolis Rd Ste 100
Odenton, MD 21113-1622

Phone

(757) 969-7591

NPI assigned

Oct 14, 2019

Last updated

Sep 22, 2020By 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

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00182

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

• Greater Maryland Pain Management, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Odenton, MD
  • NPI 1710312723
  Medicare reassignment
• Greater Maryland Pain Management, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Annapolis, MD
  • NPI 1346135902
  NPD
• Kindred Hair & Skin Center, LLC

  • Dermatology Physician
  • Marriottsville, MD
  • NPI 1992220826
  NPD (past)

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1457993222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 VOLUNTEER TRL",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 ANNAPOLIS RD STE 100",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131622",
            "telephone_number": "757-969-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Graham
• Greater Heights Healthcare Services LLC
• Greater Heights Healthcare Services LLC
• Greater Maryland Pain Management, LLC
• Jennifer Greb
• Marissa Green
• Trevor Stanley Greene, DDS
• Greensfelder Chiropractic, Inc. (Odenton Chiropract)
• John R Greensfelder, D.C.
• Grey Phoenix LLC (Avender Health Services)

• Physician Assistant in Odenton, MD
• Providers in Odenton, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.