Individual provider Active NPI

Christopher Scott Green, MD

  • General Practice Physician
  • Lebanon, IN
National Provider Identifier
1902284342
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01080947A Issued in IN
Practice address
2705 N Lebanon St Ste 300
Lebanon, IN 46052
Phone
(765) 485-8649
Fax
(765) 485-8650
NPI assigned
May 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01080947A IN
Pediatrics Physician 208000000X 01080947A IN
General Practice Physician 208D00000X 01080947A IN Primary

Addresses

Primary practice location

2705 N Lebanon St Ste 300
Lebanon, IN 46052

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other identifiers 1

IdentifierTypeStateIssuer
201292650MedicaidIN

Other names 1

  • Chris Green Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgreen@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180918002800 IN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1355652256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

2505 N Lebanon St
Lebanon, IN 46052-8613
Phone (765) 485-8830

2705 N Lebanon St
Lebanon, IN 46052-8621

2705 N Lebanon St
Lebanon, IN 46052-8622

6085 Heartland Dr
Zionsville, IN 46077-4433

Hospital & facility affiliations

  • Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
  • Witham Health Services Hospital, Lebanon, IN, CCN 150104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01080947AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Nov 1, 2018 Accepting new patients
Witham Memorial Hospital CurrentSince Nov 1, 2018 Accepting new patients

Locations

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2705 N Lebanon St
Ste 300
Lebanon, IN 46052
Phone (765) 482-8649

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1902284342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 300",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "46052",
            "telephone_number": "765-485-8649",
            "fax_number": "765-485-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-18",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01080947A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01080947A",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01080947A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201292650",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgreen@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 300",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "GREEN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.