Lee Clark Green, EMT-B

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

3203058614 Issued in MI

Practice address

1410 S Telegraph Rd
Bloomfield Hills, MI 48302-0046

Phone

(248) 456-8150

NPI assigned

Aug 5, 2017

Last updated

Aug 5, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501891200000",
    "number": "1831614361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MANN RD LOT 141",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464271",
            "telephone_number": "248-410-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020046",
            "telephone_number": "248-456-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LEE",
        "middle_name": "CLARK",
        "credential": "EMT-B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-05",
        "last_updated": "2017-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "MI",
            "license": "3203058614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Expressions Dental Centers P C
• Great Lakes Senior Homes Inc.
• Sheena Green-McCree
• Bridget N Green, LPC
• Jennifer Dara Green, ND
• Frank J Greene, M.D.
• Francine Lisa Greenfield, D.D.S.
• Elliott I Greenspan, D.O.
• Sangeeta Grewal
• David S Grey, MD

• Basic Emergency Medical Technician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Basic Emergency Medical Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2017; 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.