James Earl Green

Primary specialty

PharmacistTaxonomy code 183500000X

License

040660 Issued in MO

Practice address

1401 Old Exeter Rd
Walmart Pharmacy #0914
Cassville, MO 65625-9430

Phone

(417) 847-3180

Fax

(417) 847-3650

NPI assigned

Sep 16, 2015

Last updated

Sep 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Jim Earl Green Other name

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1639548944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 OLD EXETER RD",
            "address_2": "WALMART PHARMACY #0914",
            "city": "CASSVILLE",
            "state": "MO",
            "postal_code": "656259430",
            "telephone_number": "417-847-3180",
            "fax_number": "417-847-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 OLD EXETER RD",
            "address_2": "WALMART PHARMACY #0914",
            "city": "CASSVILLE",
            "state": "MO",
            "postal_code": "656259430",
            "telephone_number": "417-847-3180",
            "fax_number": "417-847-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "040660",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "8917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIM",
            "last_name": "GREEN",
            "middle_name": "EARL",
            "prefix": "MR.",
            "credential": "R.PH.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Holly Jo Henderson, L.P.C.

• Pharmacist in Cassville, MO
• Providers in Cassville, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.