Henry B Green, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36001483 Issued in OH

Practice address

1021 Sandusky St Ste a
Perrysburg, OH 43551

Phone

(419) 666-5299

Fax

(419) 666-9762

NPI assigned

Jul 20, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1912906033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 SANDUSKY ST STE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513120",
            "telephone_number": "419-666-5299",
            "fax_number": "419-666-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 SANDUSKY ST STE A",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-666-5299",
            "fax_number": "419-666-9762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "928 Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Rossford",
            "state": "OH",
            "postal_code": "434601333",
            "country_code": "US",
            "telephone_number": "419-666-5299",
            "fax_number": "419-666-9762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HENRY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36001483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE MEDICAL EQUIPMENT",
            "identifier": "0697670001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123806",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Medical Services LLC (Great Lakes Urgent Care)
• Great Lakes Medical Services LLC
• Great Lakes Medical Services LLC
• Great Lakes Nursing LLC
• Christina Michelle Green, MA
• Rimple Grewal, DMD
• Grewaldental Care LLC
• McKayla Cheyanne Griffith
• Sarah Griggs, FNP-C
• Guardian Speech Therapy

• Podiatrist in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.