Active NPI
Glenna Green, FNP-BC
- Family Nurse Practitioner
- Buchanan, GA
National Provider Identifier
1922565076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN208826
- Practice address
- 139 Duncan Rd
Buchanan, GA 30113-2366 - Phone
- (404) 831-9271
- NPI assigned
- Feb 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN208826 | GA | Primary |
Addresses
Primary practice location
139 Duncan Rd
Buchanan, GA 30113-2366
Mailing address
139 Duncan Rd
Buchanan, GA 30113-2366
Phone (404) 831-9271
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Www.cobbcsb.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN208826 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Rivers CSB | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Dalton, GA
- NPI 1164585543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1922565076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 DUNCAN RD",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "301132366",
"telephone_number": "404-831-9271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 DUNCAN RD",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "301132366",
"telephone_number": "404-831-9271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "GLENNA",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-25",
"last_updated": "2021-10-06",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN208826",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Www.cobbcsb.com",
"affiliation": "N",
"address_1": "1758 County Services Pkwy SW",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300084012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Buchanan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.