John Green III

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004305 Issued in AR

Practice address

358 East Valley Street
Yellville, AR 72687-0409

Phone

(870) 449-7000

NPI assigned

Apr 22, 2015

Last updated

Mar 19, 2019By the provider in NPPES

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

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Icp Arkansas Aco Billing LLC

  • Clinical Nurse Specialist
  • Maumelle, AR
  • NPI 1679157838
  Medicare reassignment NPD
• SHC Medical Partners of Arkansas, LLC

  • Nurse Practitioner
  • Little Rock, AR
  • NPI 1821830795
  Medicare reassignment NPD
• Venvisor Health of Ar PA

  • Nurse Practitioner
  • Bentonville, AR
  • NPI 1992553028
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  AR

  Medicare reassignment NPD
• Boston Mountain Rural Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Marshall, AR
  • NPI 1720096027
  NPD (past)

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1689061129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501060",
            "telephone_number": "870-448-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 EAST VALLEY STREET",
            "city": "YELLVILLE",
            "state": "AR",
            "postal_code": "726870409",
            "telephone_number": "870-449-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duffy Chiropractic Inc
• Korbin Riley Duffy, DC
• Henry Esperon
• Molly Fila
• Jodi Marie Gibson, ANP
• Sheila Groblebe
• Harps Food Stores Inc (Harps Pharmacy #189)
• Health Resources of Arkansas
• John Michael Hilvert, MSPT
• Lisa Shannon Hubbard, LAC, LADAC

• Family Nurse Practitioner in Yellville, AR
• Providers in Yellville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.