Green Mountain Personalized Care, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

GREEN MOUNTAIN PERSONALIZED CARE, INC.

Practice address

5000 Fawn Meadows
San Antonio, TX 78240-1539

Phone

(210) 696-1539

Fax

(210) 641-7881

NPI assigned

Feb 14, 2020

Organization subpart

No

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

Authorized official

Name

Tangina Edwards

Title

Paralegal

Phone

(602) 313-4556

Specialties & licenses 1

Addresses

Other names 1

• Patriot Heights Personal Care Doing business as

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581638400000",
    "number": "1912530239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 FAWN MDWS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401539",
            "telephone_number": "210-696-1539",
            "fax_number": "210-641-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 FAWN MEADOWS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401539",
            "telephone_number": "210-696-1539",
            "fax_number": "210-641-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN PERSONALIZED CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "TANGINA",
        "authorized_official_title_or_position": "PARALEGAL",
        "authorized_official_telephone_number": "602-313-4556"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patriot Heights Personal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Green Mountain Healthcare LLC
• Jarra L Green-Calderon, APRN, FNP-C, BC-ADM
• Amanda Donelle Green, NP
• Brenner Green
• Brittany Lauren Green, APRN AGACNP-BC
• Brooke Green, D.C.

• In Home Supportive Care Agency in San Antonio, TX
• Providers in San Antonio, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.