Susan Robin Green, MSN, CRNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN266978L Issued in PA

Practice address

131 E Chelten Ave
Philadelphia Public Health Dept Health Care Center #9
Philadelphia, PA 19144

Phone

(215) 685-5701

Fax

(215) 685-5257

NPI assigned

May 2, 2007

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 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susan.green@pdphahs.eclinicaldirectplus.com

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.

• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1942317094
  Medicare reassignment NPD
• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1417064353
  NPD
• City of Philadelphia

  • Clinical Medical Laboratory
  • Phila, PA
  • NPI 1689688798
  NPD
• City of Philadelphia

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1427165307
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790906840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 HENRY AVE",
            "address_2": "C15",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19128",
            "telephone_number": "215-487-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E CHELTEN AVE",
            "address_2": "PHILADELPHIA PUBLIC HEALTH DEPT HEALTH CARE CENTER #9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19144",
            "telephone_number": "215-685-5701",
            "fax_number": "215-685-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SUSAN",
        "middle_name": "ROBIN",
        "credential": "MSN,  CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "RN266978L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN266978L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBSTETRIC GYNECOLOGY",
            "identifier": "VP004121G",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Green, LCSW
• Sherry Green, MSW, LBS
• Sophie Helen Green, MD
• Stacie Diane Green
• Stephanie Marie Green
• Tkeyah Krystal Green
• William Green III
• Meridith Greenbaum, LCSW
• Steven S Greenbaum, MD
• Adam Seth Greenberg, CRNP

• Women's Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Women's Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.