WALTER CRAIG GREEN JR. (NPI# 1376971317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376971317 |
| Entity Type | Individual |
| Full Name | WALTER CRAIG GREEN JR. |
| Practice Address |
259 Bill France Blvd. Suite 200 Daytona Beach FL 32114 |
| Mailing Address |
1400 South Nova Rd Apt185 Daytona Beach FL 32114 |
| Practice Telephone | 3862068071 |
| Mailing Telephone | 3863348969 |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144836404 | Walter J. Green | Counselor | 1120 Mossy Knoll Dr, Cordova, TN 38018-6671 | 2020-09-21 |
| 1447412598 | Walter Russell Green | Durable Medical Equipment & Medical Supplies | 5131 Roosevelt Ave, San Antonio, TX 78214-3219 | 2008-06-30 |
| 1306051073 | Walter Howard Green | Internal Medicine | 16 Fort River Rd, Verona, VA 24482-0951 | 2007-05-14 |
| 1962591487 | Walter Franklin Green IIi | General Practice | 51 North Liberty Street, Harrisburg, VA 22802-3740 | 2006-10-12 |
| 1588106504 | Walter W Green IIi | Chiropractor | 7204 Main St, Ste 200, The Colony, TX 75056 | 2016-11-08 |
| 1922461805 | Walter Green | Student in an Organized Health Care Education/Training Program | 464 Congress Ave, Suite #260, New Haven, CT 06519-1361 | 2016-03-30 |
| 1558751487 | Walter Green IIi | Dentist | 1 Freedom Way, Augusta, GA 30904-6258 | 2015-01-30 |
| 1356357982 | Walter L Green | Emergency Medicine | 5323 Harry Hines Blvd, Dallas, TX 75390-7201 | 2006-08-01 |
| Street Address |
259 BILL FRANCE BLVD. SUITE 200 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477077451 | Sharon Denise Astrologo | Case Manager/Care Coordinator | 421 S. Keech St., Daytona Beach, FL 32164 | 2017-08-01 |
| 1841746658 | Terrell Irvin | Case Manager/Care Coordinator | 240 N. Frederick Ave, Daytona Beach, FL 32114 | 2016-08-31 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1871912329 | Darrell Anthony Shell | Case Manager/Care Coordinator | 435 S Ridgewood Ave # 118, Daytona Beach, FL 32114-4927 | 2014-04-14 |
| 1477806743 | Rhonda Levette Williams | Case Manager/Care Coordinator | 827 Kottle Cir N, Daytona Beach, FL 32114-4720 | 2012-10-23 |
| 1700135308 | Fred Baker | Case Manager/Care Coordinator | 160 N. Beach St., Daytona Beach, FL 32114 | 2012-08-29 |
| 1740538933 | Raegan L Jones | Case Manager/Care Coordinator | 160 North Beach Street, Daytona Beach, FL 32114-3314 | 2012-08-21 |
| 1083980387 | Teresa M Broxton | Case Manager/Care Coordinator | 401 N Ridgewood Avenue, Daytona Beach, FL 32114 | 2012-03-30 |
| 1396971156 | Erica N Simpson | Case Manager/Care Coordinator | 521 Cannon St, Daytona Beach, FL 32114-2503 | 2009-06-08 |
| 1922253442 | Chantel Kafayat Johnson | Case Manager/Care Coordinator | 240 N. Frederick Ave., Suite A, Daytona Beach, FL 32114 | 2008-11-25 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.