Khadijah Green

Primary specialty

Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X

License

264307 Issued in SC

Practice address

219 Bill Salley Rd
Orangeburg, SC 29115-8769

Phone

(803) 664-0801

NPI assigned

Mar 12, 2026

Last updated

Mar 12, 2026By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1639026347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 BILL SALLEY RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291158769",
            "telephone_number": "803-664-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 BILL SALLEY RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291158769",
            "telephone_number": "803-664-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KHADIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "SC",
            "license": "264307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Bryant Graham
• Kathryn Zeigler Gramling, RN MSN
• Rebecca S Gramling, RPH
• Yolanda Green Hanton
• Breneshia Green
• Loretta W. Green, LMSW
• Shavonna Green
• Stephanie Green, MA REHAB COUNSELING
• Vicki Clinton Green, APRN, BC
• Asha Greene

• Nurse Massage Therapist (NMT) in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Nurse Massage Therapist (NMT) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.