Individual provider Active NPI

Victoria Carriesa Green, NP

  • Acute Care Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1982106373
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN207510 Issued in GA
Practice address
1501 Milstead Rd NE Ste 110
Conyers, GA 30012-3849
Phone
(770) 496-9430
Fax
(404) 891-4947
NPI assigned
Mar 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN207510 GA Primary

Addresses

Primary practice location

1501 Milstead Rd NE Ste 110
Conyers, GA 30012-3849

Mailing address

1835 Savoy Dr Ste 203
Atlanta, GA 30341-1073

Other practice location 1

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address victoria.greenagacnpbc.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122000793 GA Practitioner - Nurse Practitioner 3870961907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

1501 Milstead Rd NE
Suite 110
Conyers, GA 30012-3849
Phone (770) 760-9949

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC CurrentSince Jan 1, 2024 Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince Jan 1, 2024 Accepting new patients
The Emory Clinic Inc CurrentSince Nov 16, 2022 Accepting new patients
Northside Imaging LLC Past Accepting new patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1501 Milstead Rd NE
Ste 110
Conyers, GA 30012
Phone (770) 460-9949

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: victoria.greenagacnpbc.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1982106373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR STE 203",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MILSTEAD RD NE STE 110",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123849",
            "telephone_number": "770-496-9430",
            "fax_number": "404-891-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421606",
            "country_code": "US",
            "telephone_number": "404-851-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "VICTORIA",
        "middle_name": "CARRIESA",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN207510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victoria.greenagacnpbc.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct edge",
            "address_1": "1000 Johnson Ferry Rd",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.