Kathryn Green, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.007245RX Issued in OH

Practice address

2510 Commons Blvd Ste 210
Beavercreek, OH 45431-3821

Phone

(937) 429-0607

Fax

(937) 702-9041

NPI assigned

Oct 27, 2021

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1639833569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-429-0607",
            "fax_number": "937-702-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 COMMONS BLVD STE 210",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313821",
            "telephone_number": "937-429-0607",
            "fax_number": "937-702-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATHRYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.007245RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graceworks Enhanced Living (Grant A)
• Elyse Graves, MA CCC-SLP
• Cassandra Noel Graybill, M.D.
• Green and Guirnalda Family Health Center
• Deasia Marie Green-Brown
• Sloane Green
• Greene Dental Associates
• Greene Memorial Hospital (GMH Urgent Care)
• Greene Memorial Hospital
• Greene Memorial Hospital Services Inc

• Medical Physician Assistant in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.