Stephanie Tracie Green, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0999562-NP Issued in CO

Practice address

1720 Jet Stream Dr Ste 200
Colorado Springs, CO 80921-3938

Phone

(719) 635-3764

Fax

(719) 635-7593

NPI assigned

Feb 16, 2024

Reactivated

Oct 9, 2025

Last updated

Oct 15, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evergreen Health Institute

  • Family Medicine Physician
  • Peyton, CO
  • NPI 1093687444
  Medicare reassignment NPD (past) Authorized official
• Apex Physical Medicine and Rehabilitation Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Colorado Springs, CO
  • NPI 1326229287
  Medicare reassignment NPD
• Sunrise Health Care, PC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1164662052
  Medicare reassignment NPD
• Evergreen Health and Wellness LLC

  • Adult Medicine Physician
  • Peyton, CO
  • NPI 1902791031
  Authorized official Same address or phone
• Evergreen Health Institute

  • Public Health or Welfare Agency
  • Peyton, CO
  • NPI 1255203493
  NPD (past) Authorized official
• Evergreen Health Institute

  • Family Medicine Physician
  • Peyton, CO
  • NPI 1417822099
  NPD (past) Authorized official
• Apex Physical Medicine and Rehabilitation Professional LLC

  • Physical Medicine & Rehabilitation Physician
  • Colorado Springs, CO
  • NPI 1548093032
  NPD
• Apex Physical Medicine and Rehabilitation Professional LLC

  • Clinical Medical Laboratory
  • Colorado Springs, CO
  • NPI 1609344290
  NPD
• Four Points Family Medical Center Inc

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1306998596
  NPD (past)
• West Two Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1588320964
  NPD (past)

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1831954098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 LOUVRE PT",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318225",
            "telephone_number": "304-860-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 JET STREAM DR STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809213938",
            "telephone_number": "719-635-3764",
            "fax_number": "719-635-7593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1605 N Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809092828",
            "country_code": "US",
            "telephone_number": "719-635-3764",
            "fax_number": "719-635-7593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "STEPHANIE",
        "middle_name": "TRACIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "deactivation_date": "2025-09-09",
        "reactivation_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0999562-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Green
• Nevaeh Green
• Richard J. Green, BC-HIS
• Sarah Green
• Savannah Green, PT
• Syria Malachia Green
• Tayler Green, NP
• Krista N Greenan, MD
• Daniel Greenberg
• David I Greenberg, M.D

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.