Fallon Latrice Green

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

G650252847490 Issued in FL

Practice address

5967 NW 21St St
Lauderhill, FL 33313-7604

Phone

(305) 924-3333

NPI assigned

Dec 18, 2018

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• MD Go Mobile Health, Inc.

  • Non-emergency Medical Transport (VAN)
  • Fort Lauderdale, FL
  • NPI 1184232969
  NPD Authorized official

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1558833376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5967 NW 21ST ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333137604",
            "telephone_number": "305-924-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5967 NW 21ST ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333137604",
            "telephone_number": "305-924-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "FALLON",
        "middle_name": "LATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "FL",
            "license": "G650252847490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demarkus Avery Grayson-Rhule, MS
• Deborah Eve Grayson, LMHC
• Fred Grayson, DC
• Great Dental Care
• Green Health CBD, LLC
• Tafia Cora Green
• Stephanie Greer, ATC
• Omar S Griffiths
• Fanshawe Grissette
• GTG Care Ft Lauderdale LLC

• Non-emergency Medical Transport (VAN) in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Non-emergency Medical Transport (VAN) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.