JIMMY W GREEN (NPI# 1174503494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174503494 |
| Entity Type | Individual |
| Full Name | JIMMY W GREEN |
| Credential | MD |
| Practice Address |
600 Gresham Dr Norfolk VA 23507-1904 |
| Mailing Address |
Po Box 20452 Psmg-credentialing Columbus OH 43220-0452 |
| Practice Telephone | 7573883221 |
| Practice Fax Number | 7573883799 |
| Mailing Telephone | 6144422406 |
| Mailing Fax Number | 6144422410 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2014-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZF0201X |
Pathology Specialization: Forensic Pathology |
026285 | GA | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
0101-241204 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1174503494 | 05 | |
| VA | RR MEDICARE | P00396483 | 01 |
| Street Address |
600 GRESHAM DR |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900515 | Alan C. Harris | Pathology | 600 Gresham Dr, Sentara Norfolk General Hospital Path Dept, Norfolk, VA 23507-1904 | 2005-05-27 |
| 1144834193 | Ana Rosa Vilela Sangay | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-09-06 |
| 1396357901 | Sentara Reference Lab Solutions, LLC | Clinical Medical Laboratory | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-08-17 |
| 1912515610 | Ashley Conner Hihn | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-19 |
| 1396353181 | Levan Gakhokidze | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-17 |
| 1841816022 | Melissa Marie Davis | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-06-23 |
| 1801417506 | Patricia Dickerson | Respiratory Therapist, Registered | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-05-04 |
| 1871112862 | Larry Michael Newton Jr. | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-10 |
| 1710516000 | Emily Carbaugh | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-07 |
| 1700415254 | Lexie Elizabeth Neubauer | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841372455 | Steffan Rodman Lacey | Pathology | 109 N 15th Street, Suite 36, Norfolk, NE 68701 | 2006-10-20 |
| 1255378576 | Robert A Hershberg | Pathology | 6330 N Center Drive, Building 13 Suite 220, Norfolk, VA 23502-4008 | 2006-06-02 |
| 1386930451 | Kingsley Lane Anatomic Pathology | Pathology | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2011-06-27 |
| 1053607697 | Timothy Bernard Walls | Pathology | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2011-06-22 |
| 1114251899 | Wendy Rizzo | Pathology | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2009-09-28 |
| 1750517330 | Jason M. Wells | Pathology | 600 Gresham Dr, Pathology Department, Norfolk, VA 23507-1904 | 2009-06-09 |
| 1487795852 | Janet Salome Winston | Pathology | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2007-02-09 |
| 1689731515 | Michele Roullet Bak | Pathology | 600 Gresham Dr, Department of Pathology, Norfolk, VA 23507-1904 | 2007-01-02 |
| 1316000904 | Maria Z. Parizhskaya | Pathology | 600 Gresham Dr, Sentara Norfolk General Hospital Path Dept, Norfolk, VA 23507-1904 | 2006-12-18 |
| 1992874861 | Jeng-gwang Hsiu | Pathology | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2006-11-07 |
| Find all providers in NORFOLK | ||||
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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.