MR. BRYAN S GREEN (NPI# 1750311221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750311221 |
| Entity Type | Individual |
| Full Name | MR. BRYAN S GREEN |
| Credential | PA-C |
| Practice Address |
67 W Railroad St Shellman GA 39886-3100 |
| Mailing Address |
Po Box 128 Shellman GA 39886-0128 |
| Practice Telephone | 2296792100 |
| Practice Fax Number | 2296792010 |
| Mailing Telephone | 2293293295 |
| Mailing Fax Number | 2296792010 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1403 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 734127359 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2405 Osler Ct, Albany, GA 317070214 | 2294351458 | 2293172342 |
| 2601 Stuart Ave, Albany, GA 31707 | 2293293295 | 8663339249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194925115 | Bryan Lynn Green | Physical Therapist | 231 34th Ave Sw, Norman, OK 73072-4843 | 2007-07-18 |
| 1215154687 | Bryan Everett Green | Dentist | 431 Bellport Dr, Boiling Springs, SC 29316-5389 | 2007-04-19 |
| 1295791366 | Bryan Robert Green | Family Medicine | 5210 N Belt Hwy, Saint Joseph, MO 64506-1211 | 2006-04-26 |
| 1528695905 | Bryan M Green | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl, New York, NY 10029-6504 | 2020-03-25 |
| 1104115583 | Bryan Thomas Green | Physical Therapist | 1099 Medical Center Cir, Mayfield, KY 42066-1159 | 2011-04-06 |
| 1538333653 | Bryan L Green | Internal Medicine | 30 Davis Ave, White Plains, NY 10605-1041 | 2008-04-18 |
| 1528118494 | Bryan Green | Hearing Instrument Specialist | 1000 Delbon Ave Ste 7, Turlock, CA 95382-2008 | 2007-01-11 |
| 1861485963 | Bryan T Green | Internal Medicine | 103 Liner Dr, Greenwood, SC 29646-2311 | 2005-08-24 |
| Street Address |
67 W RAILROAD ST |
| City | SHELLMAN |
| State | GA |
| Zip Code | 39886-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912481482 | Kjh Medical Services | Family Medicine | 67 W Railroad St, Shellman, GA 39886-3100 | 2018-09-20 |
| 1104356302 | Betsy Diaz | Nurse Practitioner | 67 W Railroad St, Shellman, GA 39886-3100 | 2017-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992279855 | Shellman Pharmacy | Pharmacy | 75 West Railroad St., Shellman, GA 39886 | 2019-01-14 |
| 1306164496 | Daphne Dixon Puckett | Spec/Tech, Pathology | 3652 Pearl St, Shellman, GA 39886 | 2010-05-13 |
| 1134136047 | Shellman Drug Company | Pharmacy | 210 W Railroad St, Shellman, GA 39886 | 2006-08-02 |
| 1750340584 | Georgie Edwards Langford | Pharmacist | 210 West Railroad Street, Shellman, GA 39886 | 2006-03-21 |
| 1174074710 | Southwest Georgia S T E M Charter Inc | Local Education Agency (LEA) | 185 Pecan St, Shellman, GA 39886-2548 | 2016-10-19 |
| 1629041421 | Hospital Authority of Randolph County | Clinic/Center | 206 West Railroad Street, Shellman, GA 39886-5003 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992279855 | Shellman Pharmacy | Pharmacy | 75 West Railroad St., Shellman, GA 39886 | 2019-01-14 |
| 1174074710 | Southwest Georgia S T E M Charter Inc | Local Education Agency (LEA) | 185 Pecan St, Shellman, GA 39886-2548 | 2016-10-19 |
| 1306164496 | Daphne Dixon Puckett | Spec/Tech, Pathology | 3652 Pearl St, Shellman, GA 39886 | 2010-05-13 |
| 1134136047 | Shellman Drug Company | Pharmacy | 210 W Railroad St, Shellman, GA 39886 | 2006-08-02 |
| 1750340584 | Georgie Edwards Langford | Pharmacist | 210 West Railroad Street, Shellman, GA 39886 | 2006-03-21 |
| 1629041421 | Hospital Authority of Randolph County | Clinic/Center | 206 West Railroad Street, Shellman, GA 39886-5003 | 2006-02-10 |
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295657 | Hygeia Health Inc | Physician Assistant | 3983 Lavista Rd Ste 195, Tucker, GA 30084-5154 | 2020-11-06 |
| 1659970408 | Laura N Gillespie | Physician Assistant | 1800 Howell Mill Rd., Suite 450, Atlanta, GA 30318 | 2020-10-22 |
| 1306443346 | Margaret Howard | Physician Assistant | 1120 15th St # Ba8222, Augusta, GA 30912-0004 | 2020-10-02 |
| 1306453980 | Samantha Rose Ashmead | Physician Assistant | 2163 Mulberry St, East Point, GA 30344-1112 | 2020-09-28 |
| 1104433689 | Alexander Hartley Sprague | Physician Assistant | 244 13th St Ne Apt 208, Atlanta, GA 30309-3656 | 2020-09-28 |
| 1053928721 | Lynn Xinhui Guan | Physician Assistant | 1121 Johnson Ferry Rd Ste 420, Marietta, GA 30068-5420 | 2020-09-28 |
| 1285240010 | Kimberly Nicole Edwards Mclean | Physician Assistant | 516 Rocky Ridge Dr, Martinez, GA 30907-4988 | 2020-09-17 |
| 1588270391 | Buzzy Oguike | Physician Assistant | 4058 Akins Ridge Ct, Powder Springs, GA 30127-3272 | 2020-09-17 |
| 1972117919 | Gregory Zimmerman | Physician Assistant | 2669 Fleur De Lis Pl, Atlanta, GA 30360-1409 | 2020-09-08 |
| 1912511882 | Min Yang | Physician Assistant | 1076 Rolling Forest Ct, Lilburn, GA 30047-8931 | 2020-09-08 |
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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.