DR. KENNETH O GREEN (NPI# 1780680900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780680900 |
| Entity Type | Individual |
| Full Name | DR. KENNETH O GREEN |
| Credential | M.D, |
| Practice Address |
111 W Lincoln St Belleville IL 62220-2019 |
| Practice Telephone | 6182341774 |
| Practice Fax Number | 6182347979 |
| Mailing Telephone | 6182341774 |
| Mailing Fax Number | 6182347979 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2009-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 036037266 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP | 211586 | 01 |
| IL | MEDICARE RAILROAD | P00216102 | 01 |
| IL | MEDICARE RAILROAD GROUP | CH6508 | 01 |
| IL | 036037266 | 05 | |
| IL | NPI GROUP | 1376586685 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699310466 | Kenneth Leroy Green Jr. | Durable Medical Equipment & Medical Supplies | 7939 W Gulf To Lake Hwy, Crystal River, FL 34429-7931 | 2019-11-15 |
| 1366964462 | Kenneth Walter Green | Massage Therapist | 307 Rockmoor Dr, Georgetown, TX 78628-8983 | 2017-07-10 |
| 1972828895 | Kenneth James Green | Social Worker | 2505 W 71st St, Indianapolis, IN 46268-2344 | 2010-04-03 |
| 1083623367 | Kenneth E Green | Family Medicine | 1895 Elizabethtown Rd, Leitchfield, KY 42754-9138 | 2006-08-05 |
| 1659366375 | Kenneth H Green | Optometrist | 4040 W Kennedy Blvd, Tampa, FL 33609-2750 | 2005-09-19 |
| 1427229194 | Kenneth Green | Social Worker | 408 S Broadview St, Cape Girardeau, MO 63703-5725 | 2008-03-20 |
| 1508802950 | Kenneth E Green | Surgery | 1025 New Moody Ln, La Grange, KY 40031-9154 | 2006-06-22 |
| 1245281716 | Kenneth Vincent Green | Social Worker | 102 Springhill Cir, Panama City, FL 32405-3546 | 2006-05-12 |
| 1649245614 | Kenneth Peter Green | Dentist | National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-0001 | 2006-02-22 |
| 1114909512 | Kenneth R. Green | Internal Medicine | 1304 Buckley Rd, Syracuse, NY 13212-4302 | 2005-11-19 |
| Street Address |
111 W LINCOLN ST |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-2019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851157 | Donald Richard Unwin | Ophthalmology | 111 W Lincoln St, Belleville, IL 62220-2019 | 2005-06-19 |
| 1558555466 | Eyecare Management, LLC | Optometrist | 111 W Lincoln St, Belleville, IL 62220-2019 | 2007-09-04 |
| 1528064748 | Stephen Reeves Waltman | Ophthalmology | 111 W Lincoln St, Belleville, IL 62220-2019 | 2005-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356570873 | Jerome Valerian Basinski | Ophthalmology | 50 Kings Pointe, Belleville, IL 62223-2268 | 2009-07-06 |
| 1841479441 | Eugene A Chiappetta Md Pa | Ophthalmology | Five Franklin Ave, Suite 610, Belleville, NJ 07109-3566 | 2007-10-31 |
| 1336363431 | Drs Szewczyk & Nekola LLC | Ophthalmology | 4900 West Main Street, Belleville, IL 62226-4725 | 2007-04-12 |
| 1356312508 | Michael J Landolfi | Ophthalmology | 567 Franklin Ave, Belleville, NJ 07109-1540 | 2006-01-27 |
| 1841289014 | Eric S Mann | Ophthalmology | 4550 Memorial Dr Ste 350, Belleville, IL 62226-5372 | 2005-10-19 |
| 1245226703 | Paul Stanley Szewczyk | Ophthalmology | 4900 W Main St, Belleville, IL 62226-4725 | 2005-09-21 |
| 1407851157 | Donald Richard Unwin | Ophthalmology | 111 W Lincoln St, Belleville, IL 62220-2019 | 2005-06-19 |
| 1588682876 | Eugene Achille Chiappetta | Ophthalmology | 5 Franklin Ave, Suite 610, Belleville, NJ 07109-3532 | 2006-07-17 |
| 1659307858 | Eye Surgeons and Physicians, Pa | Ophthalmology | 5 Franklin Ave, Suite 209, Belleville, NJ 07109-3532 | 2006-06-23 |
| 1366484222 | Rudolph Steven Wagner | Ophthalmology | 1 Clara Maass Drive, Belleville, NJ 07109-3550 | 2006-06-12 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
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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.