Individual provider Active NPI

Lisa Ann Green, D.C.

  • Chiropractor
  • Coral Springs, FL
National Provider Identifier
1558349654
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006683 Issued in FL
Practice address
1304 N University Dr
Coral Springs, FL 33071-6623
Phone
(954) 977-0888
Fax
(954) 804-0933
NPI assigned
Jan 9, 2006
Last updated
Jan 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006683 FL Primary

Addresses

Primary practice location

1304 N University Dr
Coral Springs, FL 33071-6623

Mailing address

11350 NW 1St CT
Coral Springs, FL 33071-8174
Phone (954) 270-5610

Other identifiers 1

IdentifierTypeStateIssuer
380828900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090330000190 FL Practitioner - Chiropractic 8426115296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2925 W Cypress Creek Rd
Suite 101
Fort Lauderdale, FL 33309-1757
Phone (954) 977-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0006683FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
L a Green PA Chiropractor CurrentSince Mar 17, 1995 Accepting new patients

Locations

1304 N University Dr
Coral Springs, FL 33071
Phone (954) 556-8800

2925 W Cypress Creek Rd
Ste 101
Fort Lauderdale, FL 33309
Phone (954) 977-0888

3225 N State Road 7
Margate, FL 33063
Phone (954) 977-0888

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1558349654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 NW 1ST CT",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718174",
            "telephone_number": "954-270-5610",
            "fax_number": "954-775-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N UNIVERSITY DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716623",
            "telephone_number": "954-977-0888",
            "fax_number": "954-804-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380828900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.