Timika Nicole Green, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

304308 Issued in NY

Practice address

166 Harwood Ave
Syracuse, NY 13224-1627

Phone

(808) 990-9099

NPI assigned

May 31, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1518707017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 HARWOOD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241627",
            "telephone_number": "808-990-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 HARWOOD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241627",
            "telephone_number": "808-990-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TIMIKA",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "304308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Mayer Green, MD
• Stacey R Green, LPN
• Stephanie E Green, LPN
• Thane R Green
• Thomas G Green, MD
• David R. Greenberg, M.D.
• Gary Scott Greenberg, DMD FAGD
• Julie Simone Greenberg, RN
• Carol S Greene
• Dana Greene, PT, DIP.MPT

• Licensed Practical Nurse in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.