Christy Green, FNP
Individual provider Active NPI Family Nurse Practitioner · Jasper, TN
NPI 1992354906 · NPPES record last updated Dec 13, 2023
Key facts
- NPI
- 1992354906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 25976 (TN)
- Practice address
- 3695 Main St
Jasper, TN 37347-0417 - Phone
- (423) 815-9180
- NPI assigned
- Sep 11, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Marion Health and Wellness LLC
Practice addresses (Care Compare)
3695 Main St
Jasper, TN 37347-0417
Phone (423) 815-9180
Hospital & facility affiliations
- Parkridge Medical Center
- Memorial Healthcare System, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191025002737 | TN | Practitioner - Nurse Practitioner | 2961734892 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25976 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion Health and Wellness LLC | Current |
Accepting new patients | |
| Marion Health and Wellness LLC | Current | Accepting new patients |
Locations
3695 Main St
Jasper, TN 37347
Phone (423) 815-9180
Interoperability endpoints
- christy.green.1@29788.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 25976 | TN | Yes |
Addresses
Primary practice location
3695 Main St
Jasper, TN 37347-0417
Mailing address
3695 Main St
Jasper, TN 37347-0417
Phone (423) 815-9180
Other providers in Jasper, TN
- Glenna W. Lashley, LLC
- Abigail Elise Goncalves
- Grandview Cardiology, LLC
- Grandview Physician Group LLC
- Breanna Latisha Grant
- Melissa S Halley
- Brynna Chivaune Hamilton
- Karim D Hasnani
- Howell F Hathorne
- Gary Stephen Hayes
All providers in Jasper, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.