GREEN'S COUNTRY CLINIC, LLC (NPI# 1093240749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093240749 |
| Entity Type | Organization |
| Organization Name | GREEN'S COUNTRY CLINIC, LLC |
| Practice Address |
223 E Blackwell Ave Blackwell OK 74631-2909 |
| Practice Telephone | 5803630943 |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |
| Authorized Official Name | PHIL GREEN (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 5803630943 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
800 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
223 E BLACKWELL AVE |
| City | BLACKWELL |
| State | OK |
| Zip Code | 74631-2909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205370194 | Northern Oklahoma Dental Associates Pllc | Clinic/Center | 427 W Doolin Ave, Blackwell, OK 74631 | 2016-12-12 |
| 1184799629 | Ronald Lee Matheson | Registered Nurse | 710 So 13th, Blackwell, OK 74631 | 2006-11-21 |
| 1750300992 | Christopher Ray Chenoweth | Optometrist | 202 E Blackwell, Blackwell, OK 74631 | 2006-07-19 |
| 1518983816 | Nita L Calvin | Physician Assistant | 710 S 13th, Blackwell, OK 74631 | 2006-07-14 |
| 1548629579 | Blackwell Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 119 N Main St, Blackwell, OK 74631 | 2016-02-18 |
| 1245210954 | Luther Wayne Ghormley | General Practice | 115 W Bridge Ave, Osler Clinic, Blackwell, OK 74631 | 2006-01-19 |
| 1255355723 | Triad Medical Inc | Durable Medical Equipment & Medical Supplies | 117 N Main, Blackwell, OK 74631-0854 | 2006-07-27 |
| 1255602355 | Blackwell Hmpn, LLC | Family Medicine | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2012-01-20 |
| 1821526468 | Kay County Oklahoma Hospital Company LLC | Family Medicine | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2017-05-26 |
| 1932634573 | Kay County Oklahoma Hospital Company LLC | Clinic/Center | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2017-04-20 |
| Find all providers in zip 74631 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518983816 | Nita L Calvin | Physician Assistant | 710 S 13th, Blackwell, OK 74631 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392868 | James Scott Turner | Physician Assistant | 924 Nw 14th St, Moore, OK 73160-1610 | 2020-09-23 |
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1568920924 | Direct2u Urgent Care Pllc | Physician Assistant | 2417 County Road 1263, Blanchard, OK 73010-3123 | 2019-03-05 |
| 1538625660 | Symachia LLC | Physician Assistant | 115 N. Main St., Cashion, OK 73106 | 2019-02-13 |
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1316420086 | Lauren Anto | Physician Assistant | 2824 Classen Blvd Ste 100, Norman, OK 73071-4059 | 2018-09-10 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.