Kenneth E Green, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

24940 Issued in KY

Practice address

1025 New Moody LN
La Grange, KY 40031-9154

Phone

(502) 222-0598

Fax

(502) 222-7446

NPI assigned

Jun 22, 2006

Last updated

May 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300

  Surgery

  NPD
• Baptist Health Medical Group Inc

  dba Dawson Springs Rural Health Clinic

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Baptist Health Medical Group Inc

  dba CBC Group Consulting in Blood Disorders & Cancer

  • Hematology & Oncology Physician
  • Louisville, KY
  • NPI 1487984514
  NPD (past)
• Baptist Health Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
  • NPI 1073890695
  NPD (past)
• Baptist Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1568740447
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1508802950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PKWY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235176",
            "telephone_number": "502-489-6613",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 NEW MOODY LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319154",
            "telephone_number": "502-222-0598",
            "fax_number": "502-222-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KENNETH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "24940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6424940200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Robin Gonsman, APRN
• Megan Grace, OTR/L
• Renee Grady
• Greater Louisville Anesthesia Services, PLLC
• Jessica Michelle Green, PHARM.D.
• Roger Dean Grider, M.D.
• Stcy Grieshaber, OTR/L
• Julie Guyton, LCSW
• Macie Hale
• Erich Hangartner, APRN, FNP-C

• Surgery Physician in La Grange, KY
• Providers in La Grange, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.