Je'Dette Angelique Green, ANP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1178 Issued in AK

Practice address

2925 Debarr Rd Ste 199
Anchorage, AK 99508-2959

Phone

(907) 375-2025

NPI assigned

Dec 28, 2010

Last updated

Dec 30, 2020By the provider in NPPES

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

Other names 1

• Kiki Green Other name

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Pivotal Care Partnership LLCGroup PAC ID 2264966779, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
• Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22716/brand/1/csg/1/fhir/r4
• Direct secure messaging: je.dette.green.1@22716.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pivotal Care Partnership LLC

  • Clinic/Center
  • Anchorage, AK
  • NPI 1811596026
  Medicare reassignment Care Compare group NPD

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

• Galen Hospital Alaska, Inc.

  dba Alaska Regional Hospital

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1952348047
  Care Compare affiliation
• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1588968945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90812",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995090812",
            "telephone_number": "907-375-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 199",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-375-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JE'DETTE",
        "middle_name": "ANGELIQUE",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKI",
            "last_name": "GREEN",
            "credential": "ANP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bobbi D Green
• Brian D. Green, LPC
• Clark William Green
• Deborah Green, RN
• Eve Elaine Green, LMT
• Jyll K Green, ANP
• Kameisa J Green
• Katherine Ellen Green, MSW
• Katie Prior Green, M.D.
• Kilei Green

• Family Nurse Practitioner in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Family Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.