Individual provider Active NPI

Linda Ann Green, NP

  • Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1467986844
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71007113A Issued in IN
Practice address
4015 Gateway Blvd Ste 2120
Newburgh, IN 47630-9460
Phone
(812) 842-0907
Fax
(812) 490-7015
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28150843A IN
Acute Care Nurse Practitioner 363LA2100X 0000 IN
Nurse Practitioner 363L00000X 71007113A IN Primary

Addresses

Primary practice location

4015 Gateway Blvd Ste 2120
Newburgh, IN 47630-9460

Mailing address

4015 Gateway Blvd Ste 2120
Newburgh, IN 47630-9460
Phone (812) 842-0907

Other names 1

  • Linda Ogle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170601001226 IN Practitioner - Nurse Practitioner 6002183621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Radiation Oncology Centers LLCGroup PAC ID 8628133394, 4 clinicians
Therapy Associates, Inc.Group PAC ID 1951386275, 4 clinicians

Practice addresses (Care Compare)

4055 Gateway Blvd
Newburgh, IN 47630-7451
Phone (812) 858-2273

700 N Burkhardt Rd
Evansville, IN 47715-2740
Phone (812) 474-1110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28150843AINMDRegistered Nurse
0000INMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Radiation Oncology Centers LLC CurrentSince Dec 1, 2020 Accepting new patients
Therapy Associates Inc Nurse Practitioner CurrentSince Dec 1, 2020 Accepting new patients

Locations

700 N Burkhardt Rd
Evansville, IN 47715
Phone (812) 474-1110

4055 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-2210

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1467986844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD STE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309460",
            "telephone_number": "812-842-0907",
            "fax_number": "812-464-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 GATEWAY BLVD STE 2120",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309460",
            "telephone_number": "812-842-0907",
            "fax_number": "812-490-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LINDA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28150843A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "0000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007113A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "OGLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.