Michael Cayman Greene, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5205 E Cortland Blvd Apt 174
Flagstaff, AZ 86004-9314

Phone

(575) 640-1041

NPI assigned

Jan 18, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607212800000",
    "number": "1841764289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 E CORTLAND BLVD APT 174",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860049314",
            "telephone_number": "575-640-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 E CORTLAND BLVD APT 174",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860049314",
            "telephone_number": "575-640-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MICHAEL",
        "middle_name": "CAYMAN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-18",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER - BOARD OF CERTIFICATION",
            "identifier": "2000035823",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Green, PHARMD
• Peter Gerard Green, DDS
• Zachary Tyler Green, OD
• James S Greenan, RPH
• Mark J Greene, D.M.D.
• Greengate Intensive, LLC
• David Greenwalt
• Andrew J Gregg, D.C.
• Wesley Gregg, D.C.
• Gregory a. Cox, PA-C, PLLC

• Athletic Trainer in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2020; 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.