Individual provider Active NPI

Chandra Jordan Green

  • Pharmacist
  • New Orleans, LA
National Provider Identifier
1609181809
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15286 Issued in LA
Practice address
11297 Lake Forest Blvd
New Orleans, LA 70128-2822
Phone
(504) 248-2898
Fax
(504) 248-2892
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15286 LA Primary

Addresses

Primary practice location

11297 Lake Forest Blvd
New Orleans, LA 70128-2822

Mailing address

11297 Lake Forest Blvd
New Orleans, LA 70128-2822
Phone (504) 248-2898

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

LicenseStateTypeSpecialty
15286LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1609181809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11297 LAKE FOREST BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701282822",
            "telephone_number": "504-248-2898",
            "fax_number": "504-248-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11297 LAKE FOREST BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701282822",
            "telephone_number": "504-248-2898",
            "fax_number": "504-248-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHANDRA",
        "middle_name": "JORDAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "15286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.

Verify at the official NPI Registry.