Craig Roger Green, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4282/T1346 Issued in OH

Practice address

260 E Main St
Jackson, OH 45640-1745

Phone

(740) 286-5022

Fax

(740) 286-7000

NPI assigned

Apr 7, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Green and Brown IncGroup PAC ID 1850324252, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• DRS Green & Brown Inc

  • Optometrist
  • Jackson, OH
  • NPI 1760444095
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1699738294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E MAIN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401745",
            "telephone_number": "740-286-5022",
            "fax_number": "740-286-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E MAIN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401745",
            "telephone_number": "740-286-5022",
            "fax_number": "740-286-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CRAIG",
        "middle_name": "ROGER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4282/T1346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "0457400001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0862357",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Michelle Gilbert, CDCA
• Nathan Gilliland
• Norman L Gilmore
• Tyler Martin Glassburn, PHARM.D
• Ashley Gleichauf
• Cody Allen Greenberg
• Rebekah S Greenlee, LSW
• Kimberly N. Gregg-Cornell, PT
• Hayden O Griffith
• Kimberly Grim, LSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.