Kristina Renae Greene, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA840 Issued in TN

Practice address

980 Professional Park Dr
Suite a
Clarksville, TN 37040-5251

Phone

(931) 905-1001

Fax

(931) 905-0410

NPI assigned

May 23, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristina.greene@ahp.eclinicaldirectplus.com

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.

• Advanced Diagnostic Imaging, PC

  dba AdvancedHealth

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Advanced Diagnostic Imaging PC

  dba Ankle and Foot Centers of Nashville

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1609879782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-296-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 PROFESSIONAL PARK DR",
            "address_2": "SUITE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405251",
            "telephone_number": "931-905-1001",
            "fax_number": "931-905-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KRISTINA",
        "middle_name": "RENAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3667492",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00433226",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeleah Briyon Green
• Mark E Green, MD
• Theresa Ann Green, RDA
• William Phillip Green, DDS
• Kaycie Greene
• Heather Greer
• Greg Ray, O.D., Inc
• Kaylee Elizabeth Gregory, BT
• Krista Ann Gregory, RBT
• Sandra Gresham

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.