Individual provider Active NPI

Christopher Brian Green, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1700897774
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25222 Issued in TN
Practice address
5220 Park Ave Ste 150
Memphis, TN 38119-3548
Phone
(901) 755-2255
Fax
(901) 755-9566
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD25222 TN Primary

Addresses

Primary practice location

5220 Park Ave Ste 150
Memphis, TN 38119-3548

Mailing address

5220 Park Ave Ste 150
Memphis, TN 38119-3548
Phone (901) 755-2255

Other identifiers 2

IdentifierTypeStateIssuer
0199756OtherTNBLUE CROSS BLUE SHIELD
0122349MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051207000952 TN Practitioner - Internal Medicine 7113989005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5220 Park Ave
Suite 150
Memphis, TN 38119-3548
Phone (901) 755-2255

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • St Francis Hospital Hospital, Memphis, TN, CCN 440183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25222TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green Clinic P.C. Internal Medicine CurrentSince Oct 15, 1999 Accepting new patients

Locations

2725 Kirby Rd
Ste 1
Memphis, TN 38119
Phone (901) 369-4900

5220 Park Ave
Ste 150
Memphis, TN 38119
Phone (901) 366-1666

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1700897774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193548",
            "telephone_number": "901-755-2255",
            "fax_number": "901-755-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193548",
            "telephone_number": "901-755-2255",
            "fax_number": "901-755-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD25222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0199756",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122349",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.