Individual provider Active NPI

Collette Kenice Green

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1942871751
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2515 14TH St NE Apt 4
Washington, DC 20018-1931
Phone
(202) 489-9018
NPI assigned
Jul 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

2515 14TH St NE Apt 4
Washington, DC 20018-1931

Mailing address

4407 Rena Rd Apt 3
Suitland, MD 20746-3609
Phone (202) 489-9018

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": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1942871751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 RENA RD APT 3",
            "city": "SUITLAND",
            "state": "MD",
            "postal_code": "207463609",
            "telephone_number": "202-489-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 14TH ST NE APT 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181931",
            "telephone_number": "202-489-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COLLETTE",
        "middle_name": "KENICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.