Mary A. Green, CNM, FNP
Individual provider Active NPI Family Nurse Practitioner · Arcadia, WI
NPI 1831448299 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1831448299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4925 (WI)
- Practice address
- 895 Dettloff Dr
Arcadia, WI 54612 - Phone
- (608) 323-3373
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spring View Physician Practices LLC
Practice addresses (Care Compare)
320 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 692-5152
330 N Loretto Rd
Lebanon, KY 40033-1300
Phone (270) 699-4638
330 N Loretto Rd
Suite 500a
Lebanon, KY 40033-1308
Phone (270) 699-2229
420 N Loretto Rd
Suite 600
Lebanon, KY 40033-1634
Phone (270) 692-5139
Hospital & facility affiliations
- Spring View Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220909002855 | KY | Practitioner - Certified Nurse Midwife (CNM) | 3274782255 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4925 | WI | MD | Chiropractor |
| 148862 | WI | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spring View Physician Practices LLC | Current |
Accepting new patients | |
| Spring View Hospital LLC | Current |
Accepting new patients | |
| Spring View Hospital LLC | Current | Accepting new patients | |
| Spring View Physician Practices, LLC | Current |
Accepting new patients | |
| Spring View Physician Practices, LLC | Family | Current | Accepting new patients |
| Spring View Physician Practices, LLC | Past | Accepting new patients | |
| Spring View Hospital, LLC | Past | Accepting new patients | |
| Spring View Hospital LLC | Past | Accepting new patients |
Locations
1878 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-7505
420 N Loretto Rd
Ste 600
Lebanon, KY 40033
Phone (270) 692-5139
420 N Loretto Rd
Ste 200
Lebanon, KY 40033
Phone 2703214480 ext. 306
330 N Loretto Rd
Ste 500A
Lebanon, KY 40033
Phone (270) 699-2229
320 N Loretto Rd
Lebanon, KY 40033
Phone (270) 692-3161
330 N Loretto Rd
Lebanon, KY 40033
Phone (270) 699-2229
17 Lincoln Rdg
Springfield, KY 40069
Phone (270) 692-5272
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- mary.green.1@30070.direct.athenahealth.com
- mgreen26089@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 148862 | WI | |
| Family Nurse Practitioner | 363LF0000X | 4925 | WI | Yes |
Addresses
Primary practice location
895 Dettloff Dr
Arcadia, WI 54612
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940
Other practice location 1
464 S Saint Joseph Ave
Arcadia, WI 54612-1401
Phone (608) 323-3341
Other providers in Arcadia, WI
- Kim M Davis-Rislove
- Kaitlin S. Earley
- Christopher Ferstenou
- Capri Mara Fillmore
- Holly Marie Glanville
- Gundersen Clinic LTD
- Gundersen Clinic LTD
- Gundersen Clinic LTD
- Gundersen Clinic, LTD.
- Natasha Haines
All providers in Arcadia, WI · Family Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.