Amanda Ruth Gorden Green, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4906 Issued in OK

Practice address

395200 W 2900 Rd
Ochelata, OK 74051-2463

Phone

(918) 535-6000

Fax

(918) 535-2694

NPI assigned

Sep 29, 2009

Last updated

May 4, 2022By the provider in NPPES

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

Enrolled in TX

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

Merit-based Incentive Payment System (MIPS)

Final score

85.4 of 100Reported as group

Quality

72.78

Promoting interoperability

98

Improvement activities

40

Cost

76.77

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD
• Oklahoma State University

  dba OSU Physicians Clinical Laboratory

  • Clinical Medical Laboratory
  • Tulsa, OK
  • NPI 1326495433
  NPD (past)

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1740514306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395200 W 2900 RD",
            "city": "OCHELATA",
            "state": "OK",
            "postal_code": "740512463",
            "telephone_number": "918-535-6000",
            "fax_number": "918-535-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395200 W 2900 RD",
            "city": "OCHELATA",
            "state": "OK",
            "postal_code": "740512463",
            "telephone_number": "918-535-6000",
            "fax_number": "918-535-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEN GREEN",
        "first_name": "AMANDA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200348650 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherokee Nation
• Sarah Lynn Close, APRN
• Tracy Lyne Coquillette
• Kyah J Dixon
• Wendy Gale Fixico
• Brandon Hart
• Kayla Horton
• Kaylin Faye Jones, MSN, APRN, FNP-C
• Minor Pediatrics Kristie Minor Aprn-CNP PLLC
• Kellye Parker

• Family Medicine Physician in Ochelata, OK
• Providers in Ochelata, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.