Heidi Louise Green, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

200300796 Issued in NC

Practice address

4020 Capital Blvd Ste 102
Carolina Community Mental Health Centers
Raleigh, NC 27604-3474

Phone

(919) 875-3211

Fax

(919) 875-4122

NPI assigned

Jul 19, 2006

Last updated

Apr 1, 2010By the provider in NPPES

Sex

Female

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Carolina Behavioral Care, P.a.

  • Psychiatry Physician
  • Apex, NC
  • NPI 1932821303
  NPD (past)
• Carolina Community Mental Health Centers, Inc

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1184859761
  NPD (past)
• Triumph LLC

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1003961269
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1902825995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 CAPITAL BLVD STE 102",
            "address_2": "CAROLINA COMMUNITY MENTAL HEALTH CENTERS",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043474",
            "telephone_number": "919-875-3211",
            "fax_number": "919-875-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 CAPITAL BLVD STE 102",
            "address_2": "CAROLINA COMMUNITY MENTAL HEALTH CENTERS",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043474",
            "telephone_number": "919-875-3211",
            "fax_number": "919-875-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HEIDI",
        "middle_name": "LOUISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200300796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2018243A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD CHOICE",
            "identifier": "477015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "134VC",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134VC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenna Green, LMFT-A
• Carolyn Green
• Carolyn Ann Green
• Corinne Green, PH.D.
• Emily Marie Green, RN, IBCLC
• Iyana Sarah - Antwanette Green
• Jon Adam Green, LCSWA
• Jonathan S Green, MD
• Latonia Green
• Lavita Crutcher Green, MSSW, LCSW

• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.