Fertasia Me'Shaun Green, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13382 Issued in SC

Practice address

301 Palmetto Park Blvd
Lexington, SC 29072-7872

Phone

(803) 996-1500

NPI assigned

Jun 14, 2023

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 SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1598449902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 SHORT ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051141",
            "telephone_number": "803-873-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PALMETTO PARK BLVD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727872",
            "telephone_number": "803-996-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "FERTASIA",
        "middle_name": "ME'SHAUN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "13382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Grant, LMSW
• Tiffany B. Grant, MA, CCC-SLP
• Demetria Graves, OT
• Green Transitions MHT LLC
• Anne Martin Green
• Jasmine Green, M.A. CCC-SLP
• Mark S Green, PA
• Paula Marie Green
• Erica Greene, RN
• Harley Raye Greene, PHARMD

• Social Worker in Lexington, SC
• Providers in Lexington, SC by specialty
• Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.
• 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.