Brandon Michael Green, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

7249 Issued in OK

Practice address

1725 S Newport Ave
Tulsa, OK 74120-6837

Phone

(617) 446-3201

NPI assigned

Jun 11, 2009

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthotic & Prosthetics International

  • Durable Medical Equipment & Medical Supplies
  • North Canton, OH
  • NPI 1679305056
  NPD
• United Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Quincy, MA
  • NPI 1720511934
  NPD (past)
• United Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Dorchester, MA
  • NPI 1134127061
  NPD (past)

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1669609160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NEWPORT AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741206837",
            "telephone_number": "617-446-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NEWPORT AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741206837",
            "telephone_number": "617-446-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "7249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Country Sports Physical Medicine and Rehab PC
• Green Country Wound Care of Muskogee PC
• Joyce Green-Halford, OTRL CHT
• Amber Yvonne Green, BS
• Ashley Green
• Cassidy Nicole Green
• Cheala Green
• Christian Carl Green
• Destiny Green, MSW US
• Doris Green

• Physical Medicine & Rehabilitation Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.