Individual provider Active NPI

Roberta Lee Green

  • Contractor
  • Omaha, NE
National Provider Identifier
1932906930
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
2564 Spaulding St
Omaha, NE 68111-2957
Phone
(402) 453-2307
NPI assigned
Feb 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X NE Primary

Addresses

Primary practice location

2564 Spaulding St
Omaha, NE 68111-2957

Mailing address

2564 Spaulding St
Omaha, NE 68111-2957
Phone (402) 453-2307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1932906930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2564 SPAULDING ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681112957",
            "telephone_number": "402-453-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2564 SPAULDING ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681112957",
            "telephone_number": "402-453-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ROBERTA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.