Active NPI
Roland H Green Jr., M.D.
- Internal Medicine Physician
- Evans, GA
National Provider Identifier
1477870749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 296123-1
- Practice address
- 447 N Belair Rd
Ste 104
Evans, GA 30809-3091 - Phone
- (678) 386-6201
- NPI assigned
- Apr 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD19400 | HI | |
| Internal Medicine Physician | 207R00000X | 01089378A | IN | |
| Internal Medicine Physician | 207R00000X | MD463717 | PA | |
| Internal Medicine Physician | 207R00000X | 4301114090 | MI | |
| Internal Medicine Physician | 207R00000X | C159465 | CA | |
| Internal Medicine Physician | 207R00000X | MD190366 | OR | |
| Internal Medicine Physician | 207R00000X | DR.0062519 | CO | |
| Internal Medicine Physician | 207R00000X | ME138295 | FL | |
| Internal Medicine Physician | 207R00000X | R8749 | TX | |
| Internal Medicine Physician | 207R00000X | 071739 | GA | |
| General Practice Physician | 208D00000X | 071739 | GA | |
| Internal Medicine Physician | 207R00000X | 296123-1 | NY | Primary |
Addresses
Primary practice location
447 N Belair Rd
Ste 104
Evans, GA 30809-3091
Mailing address
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-3813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C159465 | CA | MD | Internal Medicine Physician |
| DR.0062519 | CO | MD | Internal Medicine Physician |
| ME138295 | FL | MD | Internal Medicine Physician |
| 071739 | GA | MD | Internal Medicine Physician |
| MD19400 | HI | MD | Internal Medicine Physician |
| 01089378A | IN | MD | Internal Medicine Physician |
| 4301114090 | MI | MD | Internal Medicine Physician |
| 296123-1 | NY | MD | Internal Medicine Physician |
| MD190366 | OR | MD | Internal Medicine Physician |
| R8749 | TX | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1477870749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 N BELAIR RD",
"address_2": "STE 104",
"city": "EVANS",
"state": "GA",
"postal_code": "308093091",
"telephone_number": "678-386-6201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ROLAND",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-27",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "MD19400",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01089378A",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD463717",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301114090",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "C159465",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD190366",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CO",
"license": "DR.0062519",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME138295",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "R8749",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "071739",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "071739",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "296123-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.