NPIMap

Organization Active NPI

Gregory Chad Green, OD, PC

  • Optometrist
  • Tuscaloosa, AL
National Provider Identifier
1891144259
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-773-TA-219 Issued in AL
Legal business name
GREGORY CHAD GREEN, OD, PC
Practice address
1490 Northbank Parkway
Suite 120
Tuscaloosa, AL 35406
Phone
(205) 861-2020
NPI assigned
Jun 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

Name
Dr. Gregory Chad Green, ODNPI 1689665101
Title
President
Phone
(334) 289-0466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X S-773-TA-219 AL Primary

Addresses

Primary practice location

1490 Northbank Parkway
Suite 120
Tuscaloosa, AL 35406

Mailing address

1401 US Highway 80 W
Demopolis, AL 36732-4127
Phone (334) 289-0466

Other identifiers 1

IdentifierTypeStateIssuer
S-773-TA-219OtherALSTATE LICENSE NUMBER

Other names 1

  • VisualEyes Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728001167 AL Part B Supplier - Clinic/Group Practice 5597735415 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tuscaloosa, AL; Demopolis, AL; Fayette, AL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gregory Chad Green OD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1891144259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 US HIGHWAY 80 W",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367324127",
            "telephone_number": "334-289-0466",
            "fax_number": "334-289-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 NORTHBANK PARKWAY",
            "address_2": "SUITE 120",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "35406",
            "telephone_number": "205-861-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY CHAD GREEN, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-289-0466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-773-TA-219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "S-773-TA-219",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VisualEyes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.