NPIMap

Organization Active NPI

V G Green PC Inc

  • Optometrist
  • Rolla, MO
National Provider Identifier
1639388606
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02294 Issued in MO
Legal business name
V G GREEN PC INC
Practice address
1211 Hauck Dr
Rolla, MO 65401-4900
Phone
(573) 364-6300
Fax
(573) 341-5058
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Dr. Vernon Gary Green, ODNPI 1598740375
Title
Owner
Phone
(573) 364-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T02294 MO Primary

Addresses

Primary practice location

1211 Hauck Dr
Rolla, MO 65401-4900

Mailing address

1211 Hauck Dr
Rolla, MO 65401-4900
Phone (573) 364-6300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1639388606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HAUCK DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014900",
            "telephone_number": "573-364-6300",
            "fax_number": "573-341-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HAUCK DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014900",
            "telephone_number": "573-364-6300",
            "fax_number": "573-341-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V G GREEN PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-364-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.