Individual provider Active NPI

Andrew C Green, D.C.

  • Chiropractor
  • Clemmons, NC
National Provider Identifier
1578890356
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011783-1 Issued in NY
Practice address
6000 Meadowbrook Mall CT Ste 3a
Clemmons, NC 27012-8775
Phone
(363) 893-5662
NPI assigned
Nov 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011783-1 NY Primary

Addresses

Primary practice location

6000 Meadowbrook Mall CT Ste 3a
Clemmons, NC 27012-8775

Mailing address

3868 E Robinson Rd
Amherst, NY 14228-2001
Phone (716) 564-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211002835 NC Practitioner - Chiropractic 4587708219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stagecoach Family Chiropractic PLLCGroup PAC ID 2062730765, 2 clinicians

Practice addresses (Care Compare)

6000 Meadowbrook Mall CT
Suite 3a
Clemmons, NC 27012-8775
Phone (336) 893-5662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4969NCMDMental Health Counselor
X011783-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back 2 Back Chiropractic Group LLC Chiropractor CurrentSince Sep 5, 2025 Accepting new patients
Stagecoach Family Chiropractic PLLC Chiropractor CurrentSince Apr 8, 2020 Accepting new patients
Jamestown Spine, LLC Chiropractor PastSince Mar 10, 2019 Accepting new patients
Adam Bowman D.C., P.C. Chiropractor PastSince Oct 17, 2014 Accepting new patients

Locations

6000 Meadowbrook Mall Ct
Ste 3A
Clemmons, NC 27012
Phone (336) 893-5662

6000 Meadowbrook Mall Ct
Ste 3
Clemmons, NC 27012

206 Joe Knox Ave
Ste C
Mooresville, NC 28117
Phone (704) 765-6033

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1578890356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 E ROBINSON RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282001",
            "telephone_number": "716-564-2225",
            "fax_number": "866-907-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 MEADOWBROOK MALL CT STE 3A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128775",
            "telephone_number": "363-893-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ANDREW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.