NPIMap

Individual provider Active NPI

Benny J Green, M.D.

  • Family Medicine Physician
  • Little Rock, AR
National Provider Identifier
1609873983
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C6412 Issued in AR
Practice address
14309 Cantrell Rd
Little Rock, AR 72223-4230
Phone
(501) 224-6727
Fax
(501) 224-0374
NPI assigned
Jul 1, 2005
Last updated
Jan 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C6412 AR Primary

Addresses

Primary practice location

14309 Cantrell Rd
Little Rock, AR 72223-4230

Mailing address

14309 Cantrell Rd
Suite 7
Little Rock, AR 72223-4217
Phone (501) 224-6727

Other identifiers 2

IdentifierTypeStateIssuer
080017867OtherARRAILROAD MEDICARE
101838001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000673 AR Practitioner - Family Practice 3779536669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Benny J Green MD PAGroup PAC ID 8628021508, 2 clinicians

Practice addresses (Care Compare)

14309 Cantrell Rd
Little Rock, AR 72223-4230
Phone (501) 224-6727

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C6412ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benny J Green MD PA Family Medicine CurrentSince Sep 23, 1992 Accepting new patients
B&T Advanced Health, PLLC Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

14309 Cantrell Rd
Ste 7
Little Rock, AR 72223
Phone (501) 224-6727

Interoperability endpoints

  • Direct secure messaging: bgreen2162@direct.baptist-healthar.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1609873983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14309 CANTRELL RD",
            "address_2": "SUITE 7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234217",
            "telephone_number": "501-224-6727",
            "fax_number": "501-224-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14309 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234230",
            "telephone_number": "501-224-6727",
            "fax_number": "501-224-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BENNY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080017867",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101838001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.