Jaylen Z Green, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

38136 Issued in OK

Practice address

19600 E Ross St
Tahlequah, OK 74464-0545

Phone

(539) 234-1000

NPI assigned

Mar 26, 2018

Sex

Male

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 TX

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

Practice roles

Locations

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Cherokee Nation

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Nowata, OK
  • NPI 1891703716
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD
• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  NPD (past)

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1891290599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "539-234-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "539-234-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JAYLEN",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "38136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allie Grantham, MHR, LPC, CADC
• Green Acres Residential Care
• Aelicia Fran Green
• Barbara Carlene Green, ARNP
• Charity Faith Green, LMSW-P
• Traye Andrew Green
• Marilyn Lorraine Griffin
• Daxton Thane Grigsby, PA
• Shannon Grimes
• Gritts Wellness Clinic, LLC

• Pediatrics Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.