JENNIFER S GREEN (NPI# 1588658363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588658363 |
| Entity Type | Individual |
| Full Name | JENNIFER S GREEN |
| Credential | PA-C |
| Practice Address |
4425 Paulsen St Savannah GA 31405-3637 |
| Practice Telephone | 9123556615 |
| Practice Fax Number | 9123545970 |
| Mailing Telephone | 9123556615 |
| Mailing Fax Number | 9123545970 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2019-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
004605 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
4605 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 467115303A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 St Josephs Candler Dr Fl 1, Pooler, GA 313229579 | 9123556615 | 9123510645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205249 | Jennifer Moody Green | Licensed Vocational Nurse | 16418 Brookford Dr, Houston, TX 77059-4707 | 2019-10-03 |
| 1003478801 | Jennifer C Green | Nurse Practitioner | 838 E 625 S, Layton, UT 84041-4300 | 2019-07-01 |
| 1568946978 | Jennifer Dean Green | Day Training/Habilitation Specialist | 523 2nd St E, Scott City, MO 63780-2418 | 2018-09-20 |
| 1134608458 | Jennifer Green | Occupational Therapy Assistant | 448 Pendrey Dr, Port Orange, FL 32127-9528 | 2018-08-08 |
| 1639660103 | Jennifer Green | Occupational Therapist | 4209 Mtn.terrace, Memphis, TN 38127 | 2018-05-21 |
| 1154833747 | Jennifer Green | Acupuncturist | 5000 Davis Ln Ste 106, Austin, TX 78749-3802 | 2017-11-03 |
| 1376097071 | Jennifer Green | Nurse Practitioner | 199 Douglas Dr, Hallsville, TX 75650-7321 | 2016-08-10 |
| 1982091849 | Jennifer Hannah Green | Social Worker | 11511 Douglas Ave, Apt. 206, Huntley, IL 60142-7187 | 2015-04-17 |
| 1174921357 | Jennifer Green | Contractor | 2253 Calvert St, Virginia Beach, VA 23451-1739 | 2014-12-20 |
| 1023439122 | Jennifer Michelle Green | Speech-Language Pathologist | 7055 Mexico Road Suite 1601, St. Peters, MO 63376-9998 | 2013-12-17 |
| Street Address |
4425 PAULSEN ST |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760028658 | Kelsey Byrd | Physician Assistant | 4425 Paulsen St, Savannah, GA 31405-3662 | 2019-11-26 |
| 1437649738 | Ryan Stephen Polsinelli | Physician Assistant | 4425 Paulsen St, Savannah, GA 31405-3662 | 2018-05-14 |
| 1093243545 | Michael Mcewen | Physician Assistant | 4425 Paulsen St, Savannah, GA 31405-3662 | 2017-05-30 |
| 1023544111 | Jason Miller | Physician Assistant | 4425 Paulsen St, Savannah, GA 31405-3662 | 2017-05-10 |
| 1669846812 | Alex M Gardner | Nurse Practitioner | 4425 Paulsen St, Savannah, GA 31405 | 2015-11-25 |
| 1184097313 | Epix Anesthesia of Georgia PC | Nurse Anesthetist, Certified Registered | 4425 Paulsen St, Savannah, GA 31405-3662 | 2015-11-10 |
| 1285003251 | Lindsay Blake Sharpe | Occupational Therapist | 4425 Paulsen St, Savannah, GA 31405-3662 | 2015-09-21 |
| 1730572587 | Timothy Czarnecki | Physical Therapist | 4425 Paulsen St, Savannah, GA 31405-3662 | 2015-03-17 |
| 1023410586 | Charmaine Quirimit Pham | Nurse Practitioner | 4425 Paulsen St, Savannah, GA 31405 | 2014-09-16 |
| 1407276306 | Mims Gage Ochsner IIi | Orthopaedic Surgery | 4425 Paulsen St, Savannah, GA 31405-3662 | 2014-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245643030 | Meagan Bender | Physician Assistant | 11909 Mcauley Dr Ste D, Savannah, GA 31419-1794 | 2014-06-09 |
| 1174852149 | Michael Patrick Whitledge | Physician Assistant | 1510 Marlborough Way, Savannah, GA 31406-5048 | 2009-12-21 |
| 1376786566 | Amy B Millsap | Physician Assistant | 639a Stephenson Ave, Savannah, GA 31405-5970 | 2009-04-17 |
| 1447405477 | Nicole Hope Degennaro | Physician Assistant | 720 E 71st St, Savannah, GA 31405-4907 | 2008-11-18 |
| 1649321654 | Patricia Lucille Emfinger | Physician Assistant | 225 Candler Dr Ste 300, Savannah, GA 31405-6091 | 2007-01-16 |
| 1427126812 | Thomas P Kennane | Physician Assistant | 101 Saint George Blvd Apt 10i, Savannah, GA 31419-9351 | 2006-12-01 |
| 1932219672 | Christopher Edgerton | Physician Assistant | 42 Medical Arts Ctr, Savannah, GA 31405-4415 | 2006-08-30 |
| 1669586137 | Susan Fetter | Physician Assistant | 44 Medical Arts Ctr, Savannah, GA 31405-4415 | 2006-08-19 |
| 1689689523 | William Michael Grabowski | Physician Assistant | 8 Wheeler St, Savannah, GA 31405-5710 | 2006-07-29 |
| 1538132857 | Timothy Jay Dare Jr. | Physician Assistant | 505 Eisenhower Dr, Savannah, GA 31406-2668 | 2006-02-08 |
| Find all providers in SAVANNAH | ||||
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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.