Thelma Lynette Green-Mack, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

01037601 Issued in IN

Practice address

3850 Shore Drive
Suiote 305
Indianapolis, IN 46254-5621

Phone

(317) 920-3220

Fax

(317) 920-3221

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN, FL2 enrollments

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 2

Specialty

Physical Medicine and Rehabilitation

Education

Ohio State University College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Recover Together IncGroup PAC ID 7810247533, shared by 2 NPIs, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCAAAA/Endpoint/FCAAAA

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.

• Center for Spine & Sports Rehabilitation PC

  • Physical Medicine & Rehabilitation Physician
  • Indianapolis, IN
  • NPI 1346439239
  NPD Authorized official
• Recover Together, LLC

  dba Groups Recover Together

  • Adult Mental Health Clinic/Center
  • Lawrenceburg, IN
  • NPI 1891102497
  Medicare reassignment
• Recover Together, Inc.

  dba Groups Recover Together

  • Adult Mental Health Clinic/Center
  • London, KY
  • NPI 1346736758

  FL

  Medicare reassignment
• Advanced Healthcare Associates LLP

  • Geriatric Medicine (Internal Medicine) Physician
  • Elwood, IN
  • NPI 1841225091
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1841358017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 SHORE DRIVE",
            "address_2": "SUIOTE 305",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545621",
            "telephone_number": "317-920-3220",
            "fax_number": "317-920-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 SHORE DRIVE",
            "address_2": "SUIOTE 305",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545621",
            "telephone_number": "317-920-3220",
            "fax_number": "317-920-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-MACK",
        "first_name": "THELMA",
        "middle_name": "LYNETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01037601B",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IN",
            "license": "01037601",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01037601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100130200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250010985",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000092241",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841358017",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Ann Greco, SLP
• Green Cross Foundation Inc.
• Green Say Smile LLC
• Tahja Green-Carney, LCSW
• Christine J Green-Hayes, MA
• Heather M. Green-Schembra, NP
• Ashton Monique Green-Sims, DMD
• Raina R Green-Smith, HOME CARE AGENCY
• Adam Michael Green, DO
• Alise Green

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.