Christina Suzanne Greene, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26116 Issued in FL

Practice address

12633 Blue Eagle Way
Jacksonville, FL 32225-0825

Phone

(808) 294-5858

NPI assigned

Sep 28, 2017

Sex

Female

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861901100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12633 BLUE EAGLE WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250825",
            "telephone_number": "808-294-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12633 BLUE EAGLE WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250825",
            "telephone_number": "808-294-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CHRISTINA",
        "middle_name": "SUZANNE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Greene
• Barbara J Greene
• Brenda Reed Greene, PHARMD
• Carla Isabel Greene
• Charles C Greene, MD
• Daina Paige Greene, M.D.
• Elexis Arnold Greene
• Henry L Greene, DO
• Kenda Lynelle Greene, RN
• Lakeisha Greene, MS

• Physical Therapy Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.