Active NPI
Siteria Dionne Green
- Specialist
- Greenville, SC
National Provider Identifier
1972208643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 32340
- Practice address
- 12 Mayo Dr
Greenville, SC 29605-1315 - Phone
- (864) 277-5930
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 32340 | SC | Primary |
Addresses
Primary practice location
12 Mayo Dr
Greenville, SC 29605-1315
Mailing address
15 Hicks Rd
Greenville, SC 29605-2711
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 |
|---|---|---|---|
| 32340 | SC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1972208643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 HICKS RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296052711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 MAYO DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296051315",
"telephone_number": "864-277-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "SITERIA",
"middle_name": "DIONNE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "32340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.