James Ellis Green, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G027200 Issued in GA

Practice address

526 Pearl Nix Parkway
Suite #103
Gainesville, GA 30501

Phone

(770) 535-7978

Fax

(770) 535-8050

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Mar 22, 2016 through Mar 22, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871709840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7970",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30504",
            "telephone_number": "770-535-7978",
            "fax_number": "770-535-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 PEARL NIX PARKWAY",
            "address_2": "SUITE #103",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-535-7978",
            "fax_number": "770-535-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAMES",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "G027200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0330448A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter James Gray, MD
• Casey J Graybeal, MD
• Green Willow Pediatrics
• Amy Rebecca Green, PT, DPT
• Chelsea Ariana Green
• John Guy Green III, RPH
• Kristen W Green, PH.D.
• Myron Westley Green, OTR
• Amy Elizabeth Greene
• Cynthia Fulenwider Greene

• General Practice Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.