NPIMap

Individual provider Active NPI

Sean David Green, MSN APRN FNP-BC

  • Family Nurse Practitioner
  • Mechanicsville, VA
National Provider Identifier
1902850936
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178958 Issued in VA
Practice address
7041 Lee Park Rd
Mechanicsville, VA 23111-3682
Phone
(804) 746-3505
Fax
(804) 730-8038
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP113774 TX
Family Nurse Practitioner 363LF0000X 637990 TX
Family Nurse Practitioner 363LF0000X 0024178958 VA Primary

Addresses

Primary practice location

7041 Lee Park Rd
Mechanicsville, VA 23111-3682

Mailing address

7041 Lee Park Rd
Mechanicsville, VA 23111-3682
Phone (804) 746-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050630000930 TX Practitioner - Nurse Practitioner 3779529607 Reassigns benefits to 1 organization
I20200604002344 VA Practitioner - Nurse Practitioner 3779529607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

7041 Lee Park Rd
Mechanicsville, VA 23111-3682
Phone (804) 746-3505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
637990TXMDFamily Nurse Practitioner
0024178958VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Primary Care LLC CurrentSince Jun 1, 2020 Accepting new patients
Global Therapy Services LLC CurrentSince Apr 16, 2023 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Feb 18, 2018 Accepting new patients
Commonwealth Counseling Associates Inc Past Accepting new patients

Locations

12001 South Fwy
Ste 210
Burleson, TX 76028
Phone (817) 293-8797

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1412 May St
Ft Worth, TX 76104
Phone (817) 625-8818

7041 Lee Park Rd
Mechanicsvlle, VA 23111
Phone (804) 723-3337

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Organizations & group practices 4

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 10

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1902850936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7041 LEE PARK RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113682",
            "telephone_number": "804-746-3505",
            "fax_number": "804-730-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7041 LEE PARK RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231113682",
            "telephone_number": "804-746-3505",
            "fax_number": "804-730-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SEAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSN APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP113774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "637990",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.