Roxanne Nicole Greene

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

13242 Issued in AZ

Practice address

2642 E Fairfield St
Mesa, AZ 85213

Phone

(480) 848-4281

Fax

(480) 393-7040

NPI assigned

Aug 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Basha Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Scottsdale, AZ
  • NPI 1720452543
  NPD (past)

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1679099402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 267",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 E FAIRFIELD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85213",
            "telephone_number": "480-848-4281",
            "fax_number": "480-393-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "ROXANNE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "13242",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "13242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "801 Traeger Ave",
            "city": "San Bruno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940663048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Ann Green, NMD
• Wendy Marie Green
• Cassandra Greene, LAC
• Intissar Ann Greene
• Kimberley A Greene, RN BSN
• Greenfield Dental PLLC
• Greenfield Family Medicine LLC
• Greenfields Assisted Living LLC
• Daryl Greenhall, PA
• Madeline Amelia Greenlief, PA

• Pediatric Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.