KELLY GREEN (NPI# 1255887386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255887386 |
| Entity Type | Individual |
| Full Name | KELLY GREEN |
| Credential | PA-C |
| Practice Address |
1237 Shirehall Park Ln Wake Forest NC 27587-0601 |
| Practice Telephone | 9196673714 |
| Mailing Telephone | 9196673714 |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 001006672 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013533728 | Kelly M Green | Dietitian, Registered | 12201 Stanfield Ct, Bowie, MD 20720-4439 | 2020-06-18 |
| 1093295263 | Kelly Green | Psychologist | 3535 Market St Ste 3037, Philadelphia, PA 19104-3313 | 2018-08-17 |
| 1558802975 | Kelly Green | Counselor | 15336 Devonshire St Unit 6, Mission Hills, CA 91345-2755 | 2017-03-18 |
| 1730589565 | Kelly Green | Physical Therapist | 3014 Boaires Ln, Louisville, KY 40220-2428 | 2014-08-29 |
| 1467685107 | Kelly Elizabeth Green | Psychologist | 5524 Bee Caves Road, Suite G-2, Austin, TX 78746 | 2009-08-28 |
| 1437249547 | Kelly Ray Green | Pediatrics | 19087b Greeno Rd, Fairhope, AL 36532-3899 | 2006-10-13 |
| 1801803572 | Kelly Elaine Green | Social Worker | 1604 S W S Young Dr, Killeen, TX 76543-5003 | 2006-08-02 |
| 1649230947 | Kelly Patrick Green | Optometrist | 7437 Burnet Rd, Austin, TX 78757-2244 | 2006-03-23 |
| 1346804721 | Kelly R Green | Case Manager/Care Coordinator | 2540 Billingsley Rd, Columbus, OH 43235-1990 | 2019-05-01 |
| 1235646274 | Kelly Michelle Green | Registered Nurse | 2409 Homer Clayton Dr, Guntersville, AL 35976-2207 | 2017-12-29 |
| Street Address |
1237 SHIREHALL PARK LN |
| City | WAKE FOREST |
| State | NC |
| Zip Code | 27587-0601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713080 | Catherine Restrepo | Speech-Language Pathologist | 900 S Franklin St, Ste 201, Wake Forest, NC 27587 | 2020-06-03 |
| 1942760277 | Samantha Fae Pugh | Occupational Therapist | 200 Dr. Calvin Jones Hwy, Suite 200, Wake Forest, NC 27587 | 2019-03-22 |
| 1851863609 | The Counseling Collective | Counselor | 1764 Heritage Center Drive, 204, Wake Forest, NC 27587 | 2018-12-18 |
| 1891270856 | Halston Hoke | Speech-Language Pathologist | 620 Dr. Calvin Jones Hwy Ste 200, Wake Forest, NC 27587 | 2018-09-26 |
| 1710465620 | Amy K Tarnowski | Physical Therapist | The Lodge At Wake Forest, 1151 South Main Street, Wake Forest, NC 27587 | 2018-08-02 |
| 1518452341 | Language and Literacy 365, Pllc | Speech-Language Pathologist | 956 Templeridge Rd, Wake Forest, NC 27587 | 2018-06-25 |
| 1467951723 | Justin Mitchell | Physical Therapist | 843 Durham Rd Suite 110, Wake Forest, NC 27587 | 2018-02-01 |
| 1124544499 | Carolina Concussion & Physical Medicine, Pllc | Chiropractor | 120 Capcom Aveune, Suite 104, Wake Forest, NC 27587 | 2017-08-18 |
| 1902293889 | Katherine Armine Lorch | Student in an Organized Health Care Education/Training Program | 3000 Rogers Road Ste 210, Wake Forest, NC 27587 | 2015-04-18 |
| 1437553302 | Raleigh Durham Medical Group, Pa | Family Medicine | 620 Dr Calvin Jones Highway, Ste 212, Wake Forest, NC 27587 | 2014-10-21 |
| Find all providers in zip 27587 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011641 | Sean Thompson | Physician Assistant | 620 Dr Calvin Jones Hwy Unit 212, Wake Forest, NC 27587-3100 | 2019-09-10 |
| 1255816450 | Taylor Heath | Physician Assistant | 620 Dr Calvin Jones Hwy # 212, Wake Forest, NC 27587-3100 | 2018-10-03 |
| 1588115752 | Rdmg Associates Pa | Physician Assistant | 620 Dr Calvin Jones Hwy, Ste 212, Wake Forest, NC 27587-3100 | 2016-10-21 |
| 1689958647 | Sola E Miles | Physician Assistant | 401 Wait Ave, Wake Forest, NC 27587 | 2011-10-07 |
| 1548576309 | Audrey Jean Furnas | Physician Assistant | 110 Capcom Ave Ste 130, Wake Forest, NC 27587-6531 | 2010-08-30 |
| 1235224478 | Krista Kirby | Physician Assistant | 2115 S Main St Ste A, Wake Forest, NC 27587-5011 | 2006-10-04 |
| 1497701239 | Elizabeth Irene Norton | Physician Assistant | 620 Dr Calvin Jones Hwy Ste 212, Wake Forest, NC 27587-3100 | 2006-05-25 |
| 1598738866 | Jena Engel Hoh | Physician Assistant | 3213 Rogers Rd, Wake Forest, NC 27587-3805 | 2006-02-08 |
| 1821073024 | Jessica Jarosz Bowman | Physician Assistant | 847 Wake Forest Business Park, Suite 202, Wake Forest, NC 27587-6575 | 2005-12-09 |
| 1194716241 | Clyde Richard Edwards | Physician Assistant | 1655 Wake Dr, Suite 101, Wake Forest, NC 27587-4745 | 2005-10-28 |
| Find all providers in WAKE FOREST | ||||
| City | WAKE FOREST |
| Zip Code | 27587 |
Please comment or provide details below to improve the information on KELLY GREEN.
| 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.