Michael Brian Green, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1385 Issued in WV

Practice address

HC 37 Box 213C
Lewisburg, WV 24901-9536

Phone

(304) 645-4405

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

Yes

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, last updated by the provider on Jun 8, 2016.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1982827697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196",
            "city": "FRANKFORD",
            "state": "WV",
            "postal_code": "249380196",
            "telephone_number": "304-799-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 37 BOX 213C",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249019536",
            "telephone_number": "304-645-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04112007434566",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Maria Gore
• Cynthia Marie Gore
• Darlene Carol Graham
• Greater Washington Advanced Podiatry LLC
• Marie D Green, FNP-BC
• Greenbrier Audiology and Hearing Aid Services, Inc.
• Greenbrier Center for Comprehensive Otolaryngology, PLLC
• Greenbrier Chiropractic Center, Inc.
• Greenbrier County Board of Education
• Greenbrier County Board of Education

• All providers in Lewisburg, WV
• Occupational Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.