Colleen M Green, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

239266 Issued in AZ

Practice address

1260 S Campbell Ave
Green Valley, AZ 85614-0504

Phone

(520) 407-5600

NPI assigned

Mar 8, 2020

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

Enrolled in AZ

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

University of Arizona College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609300854
  Medicare reassignment NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609420959
  NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1740079060
  NPD
• Arizona Total Care LLC

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1255228433
  NPD (past)
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1710283593
  NPD (past)
• U2Rworthit1 LLC

  • Primary Care Nurse Practitioner
  • Tucson, AZ
  • NPI 1265187900
  NPD (past)

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

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1598390791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 W BLUE STAR DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857578496",
            "telephone_number": "520-260-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140504",
            "telephone_number": "520-407-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "239266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Valley Chiropractic Center Inc.
• Green Valley Dental Specialties
• Green Valley Family Care
• Green Valley Memory Associates, LLC
• Green Valley Physical Medicine, Inc
• Vicki L Greiff, MD
• Kathy Lynn Grindle, RN
• Garth Gruenhagen, COTA
• Ernesto Gutierrez, MD
• Keila Gutierrez, M.A.

• Psychiatric/Mental Health Nurse Practitioner in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.