MATTHEW GREEN (NPI# 1679697957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679697957 |
| Entity Type | Individual |
| Full Name | MATTHEW GREEN |
| Credential | LPC |
| Practice Address |
1208 Porter Wagoner Blvd Suite 4 West Plains MO 65775-1854 |
| Practice Telephone | 4172574031 |
| Practice Fax Number | 4172564104 |
| Mailing Telephone | 4172574031 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 499305423 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558768 | Matthew S Green | Massage Therapist | 20445 Emerald Pkwy Ste 140, Cleveland, OH 44135-6031 | 2019-09-24 |
| 1114394236 | Matthew Dylan Green | Physical Therapist | 2108 Hemlock Dr, Spring Hill, TN 37174-3147 | 2015-08-24 |
| 1104176163 | Matthew Paul Green | Dentist | 12 River Terrace Ct, Apartment 204, Minneapolis, MN 55414-3713 | 2012-09-17 |
| 1619238987 | Matthew Jonathon Green | Dentist | 421 Second St, Traverse City, MI 49684-2004 | 2012-06-04 |
| 1629210992 | Matthew Reed Green | Dermatology | 2546 E 2nd St., #400, Casper, WY 82609 | 2009-04-01 |
| 1124220793 | Matthew Stuart Green | Chiropractor | 6232 La Salle Ave, Oakland, CA 94611-2804 | 2007-06-04 |
| 1144203308 | Matthew Peter Green | Medical Genetics, Ph.D. Medical Genetics | 575 Industrial Dr, Louisa, VA 23093-4146 | 2005-11-22 |
| 1427661990 | Matthew Green | Dentist | 2190 Us Highway 27 N, Sebring, FL 33870-1861 | 2020-08-25 |
| 1356982482 | Matthew Green | Behavioral Analyst | 6 Chenell Dr Ste 150, Concord, NH 03301-8505 | 2019-09-30 |
| 1750934030 | Matthew Green | Student in an Organized Health Care Education/Training Program | 374 Stockholm St, Brooklyn, NY 11237-4006 | 2019-07-16 |
| Street Address |
1208 PORTER WAGONER BLVD SUITE 4 |
| City | WEST PLAINS |
| State | MO |
| Zip Code | 65775-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487851887 | Jerry Ronnie Harper | Counselor | 1208 Porter Wagoner Blvd, Suite 4, West Plains, MO 65775-1854 | 2007-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373359 | Ozarks Medical Center | Clinic/Center | Omc/zizzer Clinic, 1013 College Street, West Plains, MO 65775 | 2020-07-17 |
| 1962958678 | Fanny Ray | Massage Therapist | 1105 Independence Drive, West Plains, MO 65775 | 2016-09-01 |
| 1295184166 | Shaunda Faye Wolfe | Case Manager/Care Coordinator | 2301 K Hwy Apt. 2, West Plains, MO 65775 | 2016-06-10 |
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1548673858 | John Tollenaar | Physical Therapist | 1480 8th Streeet, West Plains, MO 65775 | 2014-06-04 |
| 1861818080 | Raymond Eugene Richardson | Case Manager/Care Coordinator | 1015 Lanton Road, West Plains, MO 65775 | 2014-03-12 |
| 1710309083 | Jared M Sadowitz | Physical Therapist | 1100 Kentucly Ave, West Plains, MO 65775 | 2014-01-06 |
| 1346682184 | Mark L. Dake Dds, Msd and David Sander Dmd, Mds | Dentist | 181 N. Kentucky, Suite 300, West Plains, MO 65775 | 2013-07-22 |
| 1427307024 | Anita M. Nelson | Behavioral Analyst | 8388 Pr 2731, West Plains, MO 65775 | 2012-08-29 |
| 1780959684 | Ozarks Medical Center | Pharmacy | 18 Parkway Center, West Plains, MO 65775 | 2012-03-12 |
| Find all providers in zip 65775 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740694009 | Mary Loretta Rogganbuck | Counselor | 1211 Porter Wagoner #23, West Plains, MO 65775 | 2014-06-16 |
| 1851570535 | Jean Ann Dickson | Counselor | 1480 Saint Louis St, West Plains, MO 65775-5409 | 2007-10-30 |
| 1467593368 | Rachel Cobb | Counselor | 10551 County Road 9030, West Plains, MO 65775-5253 | 2007-02-12 |
| 1811007933 | Heather L. Crank | Counselor | 909 Kentucky, Ozarks Medical Center- Behavioral Healthcare, West Plains, MO 65775 | 2006-08-30 |
| 1932718400 | Bailey Hutchinson | Counselor | 1211 Porter Wagoner Blvd, West Plains, MO 65775-1826 | 2020-07-30 |
| 1932638954 | Rochelle R Smith | Counselor | 1211 Porter Wagoner Blvd # 23, West Plains, MO 65775-1826 | 2017-06-05 |
| 1184005043 | Christine Dowell | Counselor | 504 W Main St, West Plains, MO 65775-2732 | 2015-06-16 |
| 1881098515 | Tess Margaret Miley | Counselor | 1639 Bruce Smith Pkwy, West Plains, MO 65775-7691 | 2014-10-09 |
| 1417361536 | Christy Lynn Jackson | Counselor | 1100 N Kentucky Ave, West Plains, MO 65775-2029 | 2014-06-17 |
| 1932511177 | Kenneth Scott Tombley | Counselor | 1211 Porter Wagoner Blvd, #23, West Plains, MO 65775-1826 | 2014-05-22 |
| Find all providers in WEST PLAINS | ||||
| City | WEST PLAINS |
| Zip Code | 65775 |
Please comment or provide details below to improve the information on MATTHEW 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.