Individual provider Active NPI

Robyn Joy Green, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1821357088
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP121751 Issued in TX
Practice address
1935 Medical District Dr # D2.04
Dallas, TX 75235-7701
Phone
(214) 456-7467
Fax
(214) 456-7894
NPI assigned
May 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 814484 TX
Pediatric Nurse Practitioner 363LP0200X AP121751 TX Primary

Addresses

Primary practice location

1935 Medical District Dr # D2.04
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr # D2.04
Dallas, TX 75235-7701
Phone (214) 456-7467

Other identifiers 1

IdentifierTypeStateIssuer
3300238-01MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514003018 TX Practitioner - Nurse Practitioner 1254674252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
814484TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Physician Medical Services for Children Inc CurrentSince Jan 1, 2024 Accepting new patients
Dallas Physician Medical Services for Children Inc CurrentSince Jan 1, 2024 Accepting new patients
Complex Care Medical Services Corporation Past Accepting new patients

Locations

1935 Medical District Dr
Unit A
Dallas, TX 75235

1935 Medical District Dr
Ste EL171
Dallas, TX 75235

1935 Medical District Dr
#D204
Dallas, TX 75235
Phone (214) 456-7467

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

7211 Preston Rd
Ste T3920
Plano, TX 75024
Phone (214) 867-1200

Organizations & group practices 3

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1821357088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR # D2.04",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-7467",
            "fax_number": "214-456-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR # D2.04",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-7467",
            "fax_number": "214-456-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ROBYN",
        "middle_name": "JOY",
        "credential": "APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "814484",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP121751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300238-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.