Active NPI
Michael Ryan Green, LCSW-C
- Child & Adolescent Psychiatry Physician
- Baltimore, MD
National Provider Identifier
1962500496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 13148
- Practice address
- 701 W Pratt St
3Rd. FLR
Baltimore, MD 21201-1023 - Phone
- (410) 328-8476
- Fax
- (410) 328-8552
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 13148 | MD | Primary |
Addresses
Primary practice location
701 W Pratt St
3Rd. FLR
Baltimore, MD 21201-1023
Mailing address
701 W Pratt St
3Rd. FLR
Baltimore, MD 21201-1023
Phone (410) 328-8476
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13148 | MD | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962500496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W PRATT ST",
"address_2": "3RD. FLR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011023",
"telephone_number": "410-328-8476",
"fax_number": "410-328-8552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W PRATT ST",
"address_2": "3RD. FLR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011023",
"telephone_number": "410-328-8476",
"fax_number": "410-328-8552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MICHAEL",
"middle_name": "RYAN",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MD",
"license": "13148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.