Susan Tate Green

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1614 Issued in TN

Practice address

520 E Main St
Klamath Falls, OR 97601-3236

Phone

(541) 883-4754

Fax

(541) 883-4775

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1487747184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 MAIN ST STE 101",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016057",
            "telephone_number": "901-497-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E MAIN ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976013236",
            "telephone_number": "541-883-4754",
            "fax_number": "541-883-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SUSAN",
        "middle_name": "TATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "16820",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "1614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Neal Gravley, MSFP, M.ED
• Amanda Gray
• Doroteo Morelos Grayson, CRM
• Joesphine Grayson
• Marla Anne Green
• Greg Enos Acupuncture LLC
• Pamela Sue Gregg, RN, BSN
• Gabriella Lea Gregory, PEER SUPPRT
• David Anthony Gress
• Michael Thomas Griffin, LMT

• Speech-Language Pathologist in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.