Jennifer Greene, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11003054 Issued in FL

Practice address

2221 Town Center Ave Ste 121
Melbourne, FL 32940-6102

Phone

(321) 456-5665

NPI assigned

Sep 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Morales Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.greene@idealimage.com

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1770197642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962586",
            "telephone_number": "321-269-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 TOWN CENTER AVE STE 121",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329406102",
            "telephone_number": "321-456-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9337340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jennifer.Greene@idealimage.com",
            "affiliation": "N",
            "address_1": "2221 Town Center Ave Ste 121",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329406102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MORALES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charla Jean Green, LMT
• Douglas Green, M.D.
• Felicia Green
• Mary Alice Green, LMHC
• Mitchell R Greenberg, D.C.
• Kevin Greene
• Richard Michael Greene, PA-C
• Uril Coylette Greene, MD
• Whitney Mershon Greene, OTR
• Jennifer Margo Greenfield, ARNP

• Family Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.