KERRY S GREEN MD PLC (NPI# 1356523492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356523492 |
| Entity Type | Organization |
| Organization Name | KERRY S GREEN MD PLC |
| Other Organization Name | SKYLINE MEDICINE |
| Practice Address |
6112 E Brown Rd Mesa AZ 85205-4955 |
| Practice Telephone | 4809244422 |
| Mailing Telephone | 4809244422 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2012-03-08 |
| Authorized Official Name | KERRY GREEN (OWNER) |
| Authorized Official Telephone | 4809244422 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 29662 | AZ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Skyline Medicine | Doing Business As Name - Organization |
| Street Address |
6112 E BROWN RD |
| City | MESA |
| State | AZ |
| Zip Code | 85205-4955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508849985 | Stephen L Thomas | Internal Medicine | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2005-11-21 |
| 1194245746 | Taylor C Baggs | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205 | 2017-06-25 |
| 1003211822 | Erica Vice | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2014-10-23 |
| 1366791873 | Jared Duane Gunnell | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2012-08-30 |
| 1487951620 | Natalie Pearce Turley | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2011-02-24 |
| 1124358890 | Stephen Baurichter | Physical Therapist | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2010-01-01 |
| 1144349648 | Amanda Marire Barrett | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2007-03-28 |
| 1104951037 | Ws Perry LLC | Physical Therapist | 6112 E Brown Rd, Suite101, Mesa, AZ 85205-4955 | 2007-02-22 |
| 1619060266 | Sabrena L Anderson | Physician Assistant | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2006-10-02 |
| 1801835350 | Kerry Scott Green | Family Medicine | 6112 E Brown Rd, Mesa, AZ 85205-4955 | 2006-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| 1528459781 | Elizabeth Sadler | Nurse Practitioner | 4434 E Brown Rd Ste 102, Mesa, AZ 85205 | 2015-02-10 |
| 1326444324 | Katherine G Perez | Counselor | 152 N Power Rd Ste 2, Mesa, AZ 85205 | 2014-11-18 |
| 1831500800 | C.b.o Hearing | Hearing Aid Equipment | 4406 E. Main St, Suite 103, Mesa, AZ 85205 | 2014-05-13 |
| 1699195107 | Amanda Mcdaniel | Occupational Therapist | 5911 E. Fountain St., Mesa, AZ 85205 | 2014-04-23 |
| 1952640278 | Medstar Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3932 E Fairfield Cir, Mesa, AZ 85205 | 2013-02-06 |
| 1245575398 | Fabulous Smiles of Mesa | Dentist | 4434 E. Brown Rd, Ste 104, Mesa, AZ 85205 | 2012-11-30 |
| 1992087639 | Matthew Robert Millward | Pharmacist | 1935 N. Power Rd, Mesa, AZ 85205 | 2011-09-19 |
| 1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| Find all providers in zip 85205 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003474461 | Cactus Pediatric Orthopaedics, Pllc | Clinic/Center | 1500 S Dobson Rd Ste 200, Mesa, AZ 85202-4724 | 2019-05-31 |
| 1750768446 | Beth Furman, Do, LLC | Clinic/Center | 3035 S Ellsworth, Suite #103, Mesa, AZ 85212 | 2015-05-01 |
| 1053798793 | The Source Naturopathic Medical Clinic | Clinic/Center | 1932 N Mesa Dr Unit 9, Mesa, AZ 85201-1622 | 2015-05-01 |
| 1679973358 | Performance Therapies Plus LLC | Clinic/Center | 2855 E Brown Rd Ste 20, Mesa, AZ 85213-4216 | 2014-08-29 |
| 1750641403 | Banner Health Clinic | Clinic/Center | 1432 S Dobson Rd Ste 402, Mesa, AZ 85202-4777 | 2012-05-29 |
| 1659650844 | Us Medgroup Pa | Clinic/Center | 1710 W Southern, Mesa, AZ 85202 | 2011-08-05 |
| 1790950988 | Cigna Healthcare of Arizona, Inc. | Clinic/Center | 5735 E Mckellips Rd, Suite 101, Mesa, AZ 85215-2875 | 2008-04-28 |
| 1942481379 | Clouse Chiropractic Clinic LLC | Clinic/Center | 437 S Gilbert Rd Ste 14, Mesa, AZ 85204-2866 | 2007-11-14 |
| 1467453019 | Advanced Cardiac Specialists, Chartered | Clinic/Center | 515 N Mesa Dr, Ste. 100, Mesa, AZ 85201-5914 | 2005-08-04 |
| 1831737303 | Repower Medical Clinic, LLC | Clinic/Center | 7254 E Southern Ave Ste 113, Mesa, AZ 85209-2787 | 2019-12-16 |
| Find all providers in MESA | ||||
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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.