Marilyn B Green, NURSE PRACTIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

114466 Issued in MA

Practice address

500 Congress St
Quincy, MA 02169-0908

Phone

(617) 471-0033

Fax

(617) 770-4354

NPI assigned

Aug 2, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1720089683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CONGRESS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690908",
            "telephone_number": "617-471-0033",
            "fax_number": "617-770-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CONGRESS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690908",
            "telephone_number": "617-471-0033",
            "fax_number": "617-770-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARILYN",
        "middle_name": "B",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "114466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0349861",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greater Boston Orthopedic Associates LLC
• Greater Boston Smiles Pediatric Dentistry PLLC
• Greater Boston Smiles Pediatric Dentistry, PC
• Robert Greeley, LCSW
• Jillian Green, B.A.
• Meaghan Greene-Newhall, M.S.
• Jennifer A Greene, MA, MT-BC
• Afton Greenidge
• Alexandra Lee Greer, MSW
• Monique Gregg, PSYD

• Adult Health Nurse Practitioner in Quincy, MA
• Providers in Quincy, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.