Individual provider Active NPI

Christopher Michael Green, D.C.

  • Chiropractor
  • Estero, FL
National Provider Identifier
1932139805
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9176 Issued in FL
Practice address
9250 Corkscrew Rd
Ste 4
Estero, FL 33928-3208
Phone
(239) 495-1166
Fax
(239) 495-0116
NPI assigned
Jul 4, 2006
Last updated
Jan 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9176 FL Primary

Addresses

Primary practice location

9250 Corkscrew Rd
Ste 4
Estero, FL 33928-3208

Mailing address

9250 Corkscrew Rd
Ste 4
Estero, FL 33928-3208
Phone (239) 495-1166

Other identifiers 1

IdentifierTypeStateIssuer
382137400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000370 FL Practitioner - Chiropractic 7719880350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9250 Corkscrew Rd
Suite 4
Estero, FL 33928-3216
Phone (239) 495-1166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9176FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care and Rehab Center Chiropractor CurrentSince Nov 13, 2006 Accepting new patients
E and G Enterprises Inc Past Accepting new patients
Global Medical Center, LLC Past Accepting new patients

Locations

9250 Corkscrew Rd
Ste 4
Estero, FL 33928
Phone (239) 495-1166

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1932139805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 CORKSCREW RD",
            "address_2": "STE 4",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283208",
            "telephone_number": "239-495-1166",
            "fax_number": "239-495-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 CORKSCREW RD",
            "address_2": "STE 4",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283208",
            "telephone_number": "239-495-1166",
            "fax_number": "239-495-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "9176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382137400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.