Vernon Gary Green, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02294 Issued in MO

Practice address

1211 Hauck Dr
Rolla, MO 65401-4900

Phone

(573) 364-6300

Fax

(573) 341-5058

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• V G Green PC Inc

  • Optometrist
  • Rolla, MO
  • NPI 1639388606
  NPD (past) Authorized official
• Invision Family Eye Care

  • Optometrist
  • Rolla, MO
  • NPI 1649424722
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1598740375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654020490",
            "telephone_number": "573-364-6300",
            "fax_number": "573-341-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HAUCK DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014900",
            "telephone_number": "573-364-6300",
            "fax_number": "573-341-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "VERNON",
        "middle_name": "GARY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodman Medical Center PC
• Blaine Goodman
• Dennis Stephen Goodman, DO
• Karene Marie Goodman, NURSE PRACTITIONER
• Pamela N. Gray, PA-C
• W Elaine Grover, MS
• Pamela K. Grow, M.D.
• Susan Peitz Gruener, COTA/L
• Gerardo Ismael Gacer Gueco, M.D.
• Jessica Gunn, RN

• Optometrist in Rolla, MO
• Providers in Rolla, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.