DR. STACY ROBIN GREEN (NPI# 1558686162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558686162 |
| Entity Type | Individual |
| Full Name | DR. STACY ROBIN GREEN |
| Credential | M.D. |
| Practice Address |
3985 Wonderland Hill Ave Ste 103 Boulder CO 80304-1038 |
| Practice Telephone | 3037172521 |
| Mailing Telephone | 3037172521 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2020-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 208D00000X | General Practice | 50364 | CO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447346911 | Stacy L. Green | Counselor | 714 West Main St., Grass Valley, CA 95945 | 2006-10-04 |
| 1366062754 | Stacy P Green | Nurse Practitioner | 5646 Read Blvd Ste 380, New Orleans, LA 70127-3148 | 2020-04-26 |
| 1679119754 | Stacy Nicole Green | Social Worker | 510 Butler Ave, Martinsburg, WV 25405-9990 | 2019-11-22 |
| 1568937050 | Stacy Wayne Green | Physical Therapy Assistant | 1907 Refinery Rd, Gainesville, TX 76240-2111 | 2018-10-10 |
| 1811481047 | Stacy L Green | Behavior Technician | 9150 Bereford Dr, Baton Rouge, LA 70809-2403 | 2018-06-20 |
| 1326416181 | Stacy Katrina Green | Marriage & Family Therapist | 900 Church St, D2, Laurens, SC 29360-1668 | 2015-09-10 |
| 1558777094 | Stacy Lynn Green | Occupational Therapy Assistant | 525 Glenburn Ave, Cambridge, MD 21613-1414 | 2014-07-04 |
| 1245590900 | Stacy A Green | Home Health Aide | 6480 New Hampshire Ave, Takoma, MD 20912 | 2012-05-29 |
| 1437481074 | Stacy Jo Green | Nurse Practitioner | 120 Washington Towne Blvd N, Edinboro, PA 16412-1254 | 2010-02-08 |
| 1265598361 | Stacy Jaye Green | Social Worker | 500 College Ave, Worth Health Center - North Wing, Swarthmore, PA 19081-1306 | 2006-12-31 |
| Street Address |
3985 WONDERLAND HILL AVE STE 103 |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871068528 | Rocky Mountain Regenerative Medicine, Pllc | General Practice | 2260 Baseline Rd Ste 102, Boulder, CO 80302-7740 | 2018-10-09 |
| 1841548674 | Edward Cosgriff | General Practice | 5920 Longbow Dr, Boulder, CO 80301-3202 | 2012-08-28 |
| 1164790994 | Mary Dan Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2011-12-07 |
| 1376872259 | Richard Steinberg | General Practice | 2939 10th St, Boulder, CO 80304-3019 | 2009-12-23 |
| 1669023495 | Jordan Urban | General Practice | 703 Walnut St, Boulder, CO 80302-5032 | 2019-09-23 |
| 1326396599 | Michael Robert Eades | General Practice | 6525 Gunpark Dr # 150-504, Boulder, CO 80301-3346 | 2012-08-20 |
| 1871735381 | Teresa Rebibo Fox | General Practice | 4840 Riverbend Rd, 100, Boulder, CO 80301-2659 | 2009-03-30 |
| 1932340494 | Larry Eckstein, M.d., P.C. | General Practice | 2760 29th St, Suite 2-d, Boulder, CO 80301-1214 | 2009-03-13 |
| 1649497066 | Diana L Wetzbarger | General Practice | 580 Mohawk Dr, Boulder, CO 80303-3712 | 2007-04-19 |
| 1902962939 | Gary Bruce Clark | General Practice | 1790 30th St, Suite 230, Boulder, CO 80301-1022 | 2006-12-27 |
| Find all providers in BOULDER | ||||
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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.