William Thomas Green, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3120/T800 Issued in OH

Practice address

1335 Southgate Pkwy
Cambridge, OH 43725-3015

Phone

(740) 439-1098

Fax

(740) 439-3165

NPI assigned

Jun 30, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1689603045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 SOUTHGATE PKWY",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437253015",
            "telephone_number": "740-439-1098",
            "fax_number": "740-439-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 SOUTHGATE PKWY",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437253015",
            "telephone_number": "740-439-1098",
            "fax_number": "740-439-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3120/T800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR FEDERAL DMERC",
            "identifier": "452082001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "9321631",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410047823",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0354674/6566685",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriella Gottke, BA,SWT
• Amy Ralynn Gould, MAE, ATC, LAT, CES
• Alicia Michelle Graham, CNP
• Seth S Gray, D.C.
• Chelsie Green
• Samantha Grewell
• Jueanina Grimm
• Rachelle Groah
• Gu Ohio, LLC
• Guernsey Anesthesia Associates, Inc.

• Optometrist in Cambridge, OH
• Providers in Cambridge, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.