Individual provider Active NPI

Deborah Sue Green, NP

  • Adult Health Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1700869930
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
121441 Issued in NC
Practice address
1309 N Elm Street
Greensboro, NC 27401
Phone
(336) 544-5400
Fax
(336) 544-5401
NPI assigned
Nov 22, 2005
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 121441 NC Primary

Addresses

Primary practice location

1309 N Elm Street
Greensboro, NC 27401

Mailing address

1309 N Elm Street
Greensboro, NC 27401
Phone (336) 544-5400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgreen13887@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20050919000625 NC Practitioner - Nurse Practitioner 7113951211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1309 N Elm St
Greensboro, NC 27401-1005
Phone (336) 544-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
121441NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Affiliated Physicians, Inc Current Accepting new patients
Moses Cone Affiliated Physicians, Inc. CurrentSince Jan 1, 2013 Accepting new patients
Moses Cone Affiliated Physicians, Inc. Adult Health CurrentSince Jan 1, 2013 Accepting new patients
Piedmont Senior Care, PLLC Current Accepting new patients

Locations

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1309 N Elm St
Greensboro, NC 27401
Phone (336) 544-5400

Interoperability endpoints

  • Direct secure messaging: dgreen13887@direct.conehealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1700869930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N ELM STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-544-5400",
            "fax_number": "336-544-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "121441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgreen13887@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1309 N Elm Street",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.