Joan Marie Green, MD
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Bozeman, MT
NPI 1659310324 · NPPES record last updated Mar 22, 2017
Key facts
- NPI
- 1659310324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- 8323 (MT)
- Practice address
- 1940 W Dickerson St Ste 207
Suite 207
Bozeman, MT 59718-6851 - Phone
- (406) 586-9735
- Fax
- (406) 582-9158
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 24, 2017 through Aug 24, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8323 | MT | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eating Disorder Center of Montana | Past | Accepting new patients | |
| Bridger Child & Adolescent Psychiatry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 8323 | MT | Yes |
Addresses
Primary practice location
1940 W Dickerson St Ste 207
Suite 207
Bozeman, MT 59718-6851
Mailing address
1940 W Dickerson St Ste 207
Suite 207
Bozeman, MT 59718-6851
Phone (406) 586-9735
Other providers in Bozeman, MT
- Great Northern Physical Therapy, LLC
- Great Turning Healing Center
- Greater Impact Inc
- Green Flag, PC
- Jeffrey Scott Green
- Kaylie Green
- Nicolette Green
- William Roper Green
- Joanna Greenbaum
- Gregory J Moos DDS PC
All providers in Bozeman, MT · Child & Adolescent Psychiatry Physician in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.