Angela Charisse Green, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86028496 Issued in FL

Practice address

1108 Summer Breeze Dr
Brandon, FL 33511-4079

Phone

(214) 257-4480

NPI assigned

Feb 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Angela Charisse Lafferty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1972060440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 SUMMER BREEZE DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114079",
            "telephone_number": "214-257-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 SUMMER BREEZE DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114079",
            "telephone_number": "214-257-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ANGELA",
        "middle_name": "CHARISSE",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "86028496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "LAFFERTY",
            "middle_name": "CHARISSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Greater Living Home Health LLC
• Greater Tampa Bay Health Care
• Kara Joy Greaves, BS, RBT
• Eric Grecco
• Latasha Lanee Green-Boyd, LCSW
• Erin Greenberg, M.D.
• Arthur Greene, LMHC
• Ashton D Greene, ARNP, PMHNP-BC
• Karen Greene
• Melissa Yvonne Greenwood, APRN

• Registered Dietitian in Brandon, FL
• Providers in Brandon, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.