Individual provider Active NPI

Carol Joy Green, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1801965009
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G8147 Issued in TX
Practice address
6624 Fannin St
19TH Floor
Houston, TX 77030-2312
Phone
(713) 442-0000
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G8147 TX Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X G8147 TX

Addresses

Primary practice location

6624 Fannin St
19TH Floor
Houston, TX 77030-2312

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 3

IdentifierTypeStateIssuer
133005212MedicaidTX
133005210MedicaidTX
133005211MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040412001490 TX Practitioner - Pediatric Medicine 4587658695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
George Washington University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G8147TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group Pediatrics CurrentSince Jun 19, 2020 Accepting new patients
Kelsey-Seybold Medical Group, PLLC Pediatrics CurrentSince Sep 2, 2010 Accepting new patients

Locations

1560 W Bay Area Blvd
Ste 100
Friendswood, TX 77546
Phone (713) 442-4400

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

6624 Fannin St
Fl 19
Houston, TX 77030

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

6624 Fannin St
Houston, TX 77030
Phone (713) 442-1500

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

23000 Highland Knolls Blvd
Katy, TX 77494
Phone (713) 442-4200

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1801965009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "19TH FLOOR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-442-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CAROL",
        "middle_name": "JOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "G8147",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "G8147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133005212",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133005210",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133005211",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.