Active NPI
Tara Rachele Green, PHARMD
- Pharmacist
- Marysville, OH
National Provider Identifier
1699350751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03223016
- Practice address
- 500 London Ave
Marysville, OH 43040-5512 - Phone
- (937) 578-4015
- NPI assigned
- Mar 10, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03223016 | OH | Primary |
Addresses
Primary practice location
500 London Ave
Marysville, OH 43040-5512
Mailing address
12750 Hickory Ridge Rd
Plain City, OH 43064-9760
Phone (614) 580-5823
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 1 |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03223016 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1699350751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12750 HICKORY RIDGE RD",
"city": "PLAIN CITY",
"state": "OH",
"postal_code": "430649760",
"telephone_number": "614-580-5823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 LONDON AVE",
"city": "MARYSVILLE",
"state": "OH",
"postal_code": "430405512",
"telephone_number": "937-578-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TARA",
"middle_name": "RACHELE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03223016",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "1",
"affiliation": "N",
"endpointDescription": "1",
"address_1": "500 London Ave",
"city": "Marysville",
"state": "OH",
"country_code": "US",
"postal_code": "430405512",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marysville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.