Caroline V Green, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903203 Issued in MS

Practice address

911 Ellis Ave
Jackson, MS 39209-6256

Phone

(601) 533-7016

Fax

(769) 333-9150

NPI assigned

Feb 22, 2019

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

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caroline.green.1@27478.direct.athenahealth.com

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.

• Sage Health Mississippi LLC

  • Primary Care Clinic/Center
  • Gulfport, MS
  • NPI 1861103400
  NPD
• McFatter Family Medical, LLC

  • Urgent Care Clinic/Center
  • Ridgeland, MS
  • NPI 1811660293
  NPD (past)

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1578020822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746085",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 ELLIS AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392096256",
            "telephone_number": "601-533-7016",
            "fax_number": "769-333-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CAROLINE",
        "middle_name": "V",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Case Management Services
• Amy Green
• Anthony Green
• April Lakeshia Green, NP
• Barbara Green, NURSE PRACTITIONER
• Dacia Lyn Green
• Danny Latrell Green, O.D.
• Deshauntra Green
• Edward Green, MD
• Ely Anthony Green, OTA/L

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.