Individual provider Active NPI

Misty Dawn Green, D.C.

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1972577906
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7917 Issued in FL
Practice address
1224 Alabar LN
Cape Coral, FL 33909
Phone
(239) 772-5777
Fax
(239) 772-5710
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7917 FL Primary

Addresses

Primary practice location

1224 Alabar LN
Cape Coral, FL 33909

Mailing address

1224 Alabar LN
Cape Coral, FL 33909-5102
Phone (239) 772-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050506000428 FL Practitioner - Chiropractic 7214977404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1224 Alabar LN
Cape Coral, FL 33909-5102
Phone (239) 772-5777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7917FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alabar Chiropractic & Rehab Center Chiropractor CurrentSince Nov 2, 2009 Accepting new patients

Locations

1224 Alabar Ln
Cape Coral, FL 33909
Phone (239) 772-5777

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1972577906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 ALABAR LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095102",
            "telephone_number": "239-772-5777",
            "fax_number": "239-214-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 ALABAR LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33909",
            "telephone_number": "239-772-5777",
            "fax_number": "239-772-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.