Active NPI
Rachel E Green, MS, ATC
- Athletic Trainer
- Indianapolis, IN
National Provider Identifier
1639282007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36001750A
- Practice address
- 201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301 - Phone
- (318) 208-5112
- Fax
- (317) 817-1220
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001318 | GA | |
| Athletic Trainer | 2255A2300X | 36001750A | IN | Primary |
Addresses
Primary practice location
201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301
Mailing address
201 Pennsylvania Pkwy
Suite 100
Indianapolis, IN 46280-2301
Phone (318) 208-5112
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001318 | GA | MD | Athletic Trainer |
| 36001750A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1639282007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462802301",
"telephone_number": "318-208-5112",
"fax_number": "317-817-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462802301",
"telephone_number": "318-208-5112",
"fax_number": "317-817-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "RACHEL",
"middle_name": "E",
"name_prefix": "Miss",
"credential": "MS, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT001318",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36001750A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.