Carli Green, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6177-12 Issued in WI

Practice address

827 Cormier Rd
Green Bay, WI 54304-4706

Phone

(920) 569-2350

NPI assigned

Jul 12, 2024

Last updated

Jul 12, 2024By 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 WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lifestyle Chiropractic & Wellness Connection LLC

  • Chiropractor
  • Green Bay, WI
  • NPI 1891897328
  Medicare reassignment NPD

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1487491833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 MARINA CIR UNIT 504",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044877",
            "telephone_number": "920-655-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044706",
            "telephone_number": "920-569-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARLI",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "6177-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Green Blanks, MSW, APSW
• Green Meadows Assisted Living LLC
• Green Ride LLC
• Green River Trans LLC
• Alex Jonathan Green, CAA
• G. Lynn Green, APNP
• Katherine A. Green, M.D.
• Katie Rose Green
• Sean Green
• Dawn Marie Greenawald

• Chiropractor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.