Active NPI
William Green
- Athletic Trainer
- Carrollton, GA
National Provider Identifier
1669892485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT001238
- Practice address
- 641 N Cliff St
Carrollton, GA 30117-2207 - Phone
- (678) 634-4776
- Fax
- (678) 839-6546
- NPI assigned
- Apr 19, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001238 | GA | Primary |
Addresses
Primary practice location
641 N Cliff St
Carrollton, GA 30117-2207
Mailing address
641 N Cliff St
Carrollton, GA 30117-2207
Phone (678) 634-4776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001238 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397865600000",
"number": "1669892485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "641 N CLIFF ST",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301172207",
"telephone_number": "678-634-4776",
"fax_number": "678-839-6546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "641 N CLIFF ST",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301172207",
"telephone_number": "678-634-4776",
"fax_number": "678-839-6546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-19",
"last_updated": "2014-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT001238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.