Kristen K Greene, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2022-03241 Issued in NC

Practice address

3150 Rogers Rd Ste 102
Wake Forest, NC 27587-4196

Phone

(919) 453-5363

NPI assigned

May 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristengreene@jmp.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment NPD
• Jeffers Mann & Artman Pediatric & Adolesent Medicine PA

  • Pediatric Adolescent Medicine Physician
  • Raleigh, NC
  • NPI 1962466631
  NPD

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1891222980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 ROGERS RD STE 102",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874196",
            "telephone_number": "919-453-5363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2406 Blue Ridge Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076692",
            "country_code": "US",
            "telephone_number": "919-786-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KRISTEN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2022-12-21",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101269808",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-03241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Paul Green, MFT
• Jessica Green, RD
• Kelly Green, PA-C
• Greene Mental Wellness, PLLC
• Catina N Greene, PMHNP
• Tracee Dionne Gregory-Harris, MSW, LCSW
• David Henry Gremillion, M.D.
• Marian C Griffin, LCSW
• William Scott Griffin, D.D.S.
• Andrew Griffith

• Pediatrics Physician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.