Sherri Lucky Green, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9102290 Issued in FL

Practice address

137 Collegiate Way-Fsu/TSHC
Tallahassee, FL 32306-2140

Phone

(850) 644-5838

Fax

(850) 644-0355

NPI assigned

Sep 5, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Atlantic Family Medical Center of Jacksonville PL

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1699872812
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619070976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 CYPRESS CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036708",
            "telephone_number": "850-459-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 COLLEGIATE WAY-FSU/TSHC",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323062140",
            "telephone_number": "850-644-5838",
            "fax_number": "850-644-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHERRI",
        "middle_name": "LUCKY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John C. Green, M.D.
• Khadija Green
• Latoya Shaquita Green
• Matthew Green
• Risa Michele Green, P.T.
• Tavian Green
• Whitney Green, MEDICAL ASSISTANT
• William Harris Green
• Xander Lee Green, AA
• Leigh Greenberg, LCSW

• Medical Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.