Individual provider Active NPI

Robert Adam Green

  • Certified Registered Nurse Anesthetist
  • West Columbia, SC
National Provider Identifier
1952745499
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
31768 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 935-8538
Fax
(803) 791-2660
NPI assigned
Apr 27, 2013
Last updated
May 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R079312 AR
Certified Registered Nurse Anesthetist 367500000X 2013012833 MO
Certified Registered Nurse Anesthetist 367500000X 31768 SC Primary
Certified Registered Nurse Anesthetist 367500000X 28221931A IN

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

879 Northwich Ave
Westfield, IN 46074-3344
Phone (870) 926-5519

Other practice location 1

879 Northwich Ave
Westfield, IN 46074-3344
Phone (870) 926-5519

Other identifiers 1

IdentifierTypeStateIssuer
201302760MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgreen201104@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150730012940 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456593680 Reassigns benefits to 5 organizations
I20250825003091 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456593680 Reassigns benefits to 1 organization
I20260429002556 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456593680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R079312ARMDRegistered Nurse
2013012833MOMDCertified Registered Nurse Anesthetist
31768SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 6, 2026 Accepting new patients
Surgery One Anesthesia, LLC CurrentSince May 12, 2018 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Shadeland Anesthesia & Pain Associates Inc. CurrentSince Aug 8, 2024 Accepting new patients
Shadeland Anesthesia & Pain Associates Inc. CurrentSince Aug 8, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 4, 2025 Accepting new patients
Jebs Anesthesia Consultants, LLC CurrentSince Jan 3, 2023 Accepting new patients
Aas Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2023 Accepting new patients

Locations

29943 Network Pl
Chicago, IL 60673

151 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

4105 Dicke Rd
Fort Wayne, IN 46804
Phone (260) 268-1000

5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551

5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203

7747 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-9104

8805 N Meridian St
Ste 200
Indianapolis, IN 46260
Phone (317) 571-5000

1601 W Lincoln Rd
Kokomo, IN 46902
Phone (765) 453-5696

3738 Landmark Dr
Ste A
Lafayette, IN 47905
Phone (765) 807-2780

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: rgreen201104@direct.lexmed.com

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1952745499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 NORTHWICH AVE",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460743344",
            "telephone_number": "870-926-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-935-8538",
            "fax_number": "803-791-2660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "879 Northwich Ave",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "IN",
            "postal_code": "460743344",
            "country_code": "US",
            "telephone_number": "870-926-5519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ROBERT",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-27",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R079312",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2013012833",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "31768",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28221931A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201302760",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgreen201104@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.