Tasha Lavette Green, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

052108 Issued in GA

Practice address

125 Eagles Walk
Suite 150
Stockbridge, GA 30281-7208

Phone

(678) 477-9230

NPI assigned

Jul 13, 2006

Sex

Female

Sole proprietor

Yes

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 GA

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tasha.green@whitefoord.gadirect.net
• Direct secure messaging: tasha.green@merg.eclinicaldirectplus.com

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.

• Meridian Education Resource Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1730305004
  Medicare reassignment NPD
• Meridian Education Resource Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1528630654
  NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1477578797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 ABRAM DR",
            "city": "CONLEY",
            "state": "GA",
            "postal_code": "302881739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EAGLES WALK",
            "address_2": "SUITE 150",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817208",
            "telephone_number": "678-477-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TASHA",
        "middle_name": "LAVETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "052108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Alcantara Green
• Jamon Laquentin Green
• Jzalynn Green, PHARMD
• Katrinia Green
• Kaysie Green
• Tunisia Green, LPN
• Vicki Johnson Green, DNP,FNP-BC,AGACNP-BC
• Sandea Anessa Greene-Harris, MD
• Vernon W Greene, D.M.D.
• Wendy March Greenway, NP

• Pediatrics Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.