Individual provider Active NPI

John Robert Green IV, MD

  • Orthopaedic Surgery Physician
  • Iowa City, IA
National Provider Identifier
1710447313
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD-52906 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2223
Fax
(319) 353-6754
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD-52906 IA
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X MD-52906 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2223

Other practice location 1

3635 Vista Ave
Saint Louis, MO 63110-2500
Phone (314) 577-8850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20250728001538 NE Practitioner - Orthopedic Surgery 7719212562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

7710 Mercy Rd
Suite 2000
Omaha, NE 68124-2323
Phone (402) 717-0820

Hospital & facility affiliations

  • CHI Health Lakeside Hospital, Omaha, NE, CCN 280130
  • CHI Health Midlands Hospital, Papillion, NE, CCN 280105
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • CHI Health Immanuel Hospital, Omaha, NE, CCN 280081

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement20
Knee replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-52906IAMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Aug 1, 2025 Accepting new patients
Alegent Creighton Clinic Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

7710 Mercy Rd
Ste 2000
Omaha, NE 68124
Phone (402) 717-0820

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

Organizations & group practices 2

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 5

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1710447313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2223",
            "fax_number": "319-353-6754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102500",
            "country_code": "US",
            "telephone_number": "314-577-8850",
            "fax_number": "314-268-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IA",
            "license": "MD-52906",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IA",
            "license": "MD-52906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.