Carly Jessica Greene

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

114 Squire Hall
Buffalo, NY 14214

Phone

(716) 829-3717

Fax

(716) 829-3895

NPI assigned

May 26, 2017

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1841728482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-829-3717",
            "fax_number": "716-829-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-829-3717",
            "fax_number": "716-829-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CARLY",
        "middle_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas John Green, PA-C
• Steven Daniel Green, M.D.
• Tyler Michael Green, PT, DPT
• Wanda R Greenaway, A-GNP-C
• Adam William Greenberg, D.C
• Daniel Greene, LCSWR
• Hayden Elyse Greene
• Jennifer A Greene, LMT
• Margaret Greene
• Thomas Greene

• Student in an Organized Health Care Education/Training Program in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.