Robert L. Green, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

082121 Issued in GA

Practice address

2501 N Patterson St
Valdosta, GA 31602-1735

Phone

(229) 433-1000

Fax

(706) 596-6723

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

University of North Carolina at Chapel Hill School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SGMC Affiliated Services LLCGroup PAC ID 5496284028, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

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 and National Provider Directory roles.

• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  Medicare reassignment Care Compare group
• Radiology Associates of Valdosta, LLC

  • Diagnostic Radiology Physician
  • Valdosta, GA
  • NPI 1134429582
  Medicare reassignment NPD
• Central Virginia Imaging, LLC

  dba Centra Central Virginia Imaging, LLC

  • Physiological Laboratory
  • Lynchburg, VA
  • NPI 1336914134
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1558386706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1524",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319021524",
            "telephone_number": "800-841-4236",
            "fax_number": "706-596-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-433-1000",
            "fax_number": "706-596-6723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Nationwide Dr",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245024272",
            "country_code": "US",
            "telephone_number": "434-237-4004",
            "fax_number": "434-237-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101042362",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "82121",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "082121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003218661A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7251505",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7206941",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Louise Gray
• Hardy Lamar Gray, DMD
• Ralph Lewis Grayson, CPO
• Demetria Covet Green Newton
• Jacqueline B. Green, LPC
• Steven Thomas Greenhaw, M D
• Greenleaf Center, LLC (Greenleaf Behavioral Health Hospital)
• Greenleaf Counseling Center
• Joshua Tyler Greenway, DMD
• Gregory E. Pye, PH.D, PC

• Diagnostic Radiology Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.
• 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.