Stacy Green Enterprises, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

STACY GREEN ENTERPRISES, LLC

Doing business as

Dr. Stacy Green, M.D., LLC

Practice address

825 S Broadway St Ste 100
Boulder, CO 80305-5932

Phone

(303) 717-2521

NPI assigned

Sep 9, 2021

Organization subpart

No

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

Authorized official

Name

Stacy Robin Green, MDNPI 1558686162

Title

Owner

Phone

(303) 717-2521

Specialties & licenses 1

Addresses

Other names 1

• Dr. Stacy Green, M.D., LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacy Robin Green, M.D.

  • General Practice Physician
  • Boulder, CO
  • NPI 1558686162
  NPD Authorized official

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1871262253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S BROADWAY ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055932",
            "telephone_number": "303-717-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S BROADWAY ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055932",
            "telephone_number": "303-717-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY GREEN ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-717-2521",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Stacy Green, M.D., LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy St Germain, CNT
• St. Vincent General Hospital District
• Maciej Stabile
• Lindsay Stack
• Natasha Stackhouse
• Margrit Staedler, LIC. AC.
• Mackenzie S Stahl-Whitaker
• Elizabeth Ann Stahl, MA, LPC
• Chelsea Stallan
• Daniela Coral Stallings

• Health Service Clinic/Center in Boulder, CO
• Providers in Boulder, CO by specialty
• Health Service Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.