Active NPI
Justin Lee Green, D.C.
- Chiropractor
- Greenwood, IN
National Provider Identifier
1992089312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08002603A
- Practice address
- 1185 W County Line Rd
Greenwood, IN 46142-5156 - Phone
- (317) 884-0995
- Fax
- (317) 882-7882
- NPI assigned
- Oct 4, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08002603A | IN | Primary |
Addresses
Primary practice location
1185 W County Line Rd
Greenwood, IN 46142-5156
Mailing address
386 Leisure LN
Greenwood, IN 46142-8529
Phone (317) 490-2648
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08002603A | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1992089312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "386 LEISURE LN",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461428529",
"telephone_number": "317-490-2648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1185 W COUNTY LINE RD",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461425156",
"telephone_number": "317-884-0995",
"fax_number": "317-882-7882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JUSTIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-04",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08002603A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.