Active NPI
Misty Lynn Green, P.T.A.
- Physical Therapy Assistant
- Kansas City, KS
National Provider Identifier
1609074137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT 6624
- Practice address
- 8437 State Ave
Kansas City, KS 66112-1842 - Phone
- (913) 299-9616
- NPI assigned
- Jul 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT 6624 | CA | Primary |
Addresses
Primary practice location
8437 State Ave
Kansas City, KS 66112-1842
Mailing address
4911 Millridge St
Shawnee, KS 66226-9752
Phone (913) 530-2779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT 6624 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1609074137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4911 MILLRIDGE ST",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662269752",
"telephone_number": "913-530-2779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8437 STATE AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661121842",
"telephone_number": "913-299-9616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MISTY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT 6624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.