Green Clinic Surgical Hospital, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

515 Issued in LA

Legal business name

GREEN CLINIC SURGICAL HOSPITAL, LLC

Practice address

1118 S Farmerville St
Ruston, LA 71270-5914

Phone

(318) 232-7700

Fax

(318) 232-1092

NPI assigned

Oct 12, 2006

Organization subpart

No

Name

Mr. James McClung

Title

Administrator

Phone

(318) 232-7186

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Green Clinic Surgical Hospital Crna Group

  • Certified Registered Nurse Anesthetist
  • Ruston, LA
  • NPI 1881877835
  NPPES parent name

Organizations this organization is a member of, according to the National Provider Directory.

• Green Clinic LLC

  • Physical Therapy Clinic/Center
  • Ruston, LA
  • NPI 1891801601

  Member Of

  NPD member

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Greene Butler, M.D.

  • Surgery Physician
  • Ruston, LA
  • NPI 1619947629
  NPD (past)
• Jacob Myles Wood, M.D.

  • Family Medicine Physician
  • Baton Rouge, LA
  • NPI 1700858255
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 14, 2008.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1700975083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705914",
            "telephone_number": "318-232-7700",
            "fax_number": "318-232-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705914",
            "telephone_number": "318-232-7700",
            "fax_number": "318-232-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CLINIC SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "MCCLUNG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-232-7186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702676",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  PROVIDER NO",
            "identifier": "60643",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Clinic LLC
• Green Clinic LLC
• Green Clinic LLC
• Green Clinic Surgical Center
• Green Clinic Surgical Hospital Crna Group
• Brittany Green
• Janie Green
• Jena Paige Green
• Kelly Green, DPT
• Keeansia Greenwood

• All providers in Ruston, LA
• General Acute Care Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.