Individual provider Active NPI

Dorothy Marie Green, FNP

  • Family Nurse Practitioner
  • Welch, WV
National Provider Identifier
1487176517
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
74119 Issued in WV
Practice address
454 McDowell St
Welch, WV 24801-2029
Phone
(304) 436-8461
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 74119 WV Primary

Addresses

Primary practice location

454 McDowell St
Welch, WV 24801-2029

Mailing address

PO Box 294
Oceana, WV 24870-0294
Phone (304) 682-2097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20170919003835 WV Practitioner - Nurse Practitioner 6901170620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Mountains Medical LLCGroup PAC ID 6709016264, 43 clinicians

Practice addresses (Care Compare)

454 McDowell St
Welch, WV 24801-2029
Phone (304) 436-8685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74119WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Mountains Medical, LLC CurrentSince Aug 1, 2017 Accepting new patients

Locations

105 S Eisenhower Dr
Beckley, WV 25801
Phone (304) 255-6404

223 Dry Hill Rd
Beckley, WV 25801

454 McDowell St
Welch, WV 24801
Phone (304) 436-8461

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1487176517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294",
            "city": "OCEANA",
            "state": "WV",
            "postal_code": "248700294",
            "telephone_number": "304-682-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 MCDOWELL ST",
            "city": "WELCH",
            "state": "WV",
            "postal_code": "248012029",
            "telephone_number": "304-436-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DOROTHY",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "74119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Welch, WV

Sources for this page

Verify at the official NPI Registry.