DR. KATHY J. GREEN (NPI# 1053464065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053464065 |
| Entity Type | Individual |
| Full Name | DR. KATHY J. GREEN |
| Credential | M.D., M.P.H. |
| Practice Address |
4586 E Highway 20 Suite B Niceville FL 32578-9724 |
| Mailing Address |
Po Box 2699 Pensacola FL 32513-2699 |
| Practice Telephone | 8508973200 |
| Mailing Telephone | 8508973200 |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2016-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME 118195 | FL | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
ME 118195 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129078 | Kathy Lynn Green | In Home Supportive Care | 2261 Pinebrook Rd, Columbus, OH 43220-4327 | 2020-09-16 |
| 1487806733 | Kathy M Green | Licensed Practical Nurse | 35311 Greenwich Ave, North Ridgeville, OH 44039-1385 | 2008-10-17 |
| 1306824784 | Kathy E Green | Nurse Practitioner | 80 State St # 310, Canton, NY 13617-1026 | 2006-01-05 |
| 1295287639 | Kathy Green | Nurse Practitioner | 5424 Discovery Park Boulevard, Bldg. B Suite 204, Williamsburg, VA 23188 | 2016-11-02 |
| 1588936488 | Kathy D. Green | Nurse Practitioner | 705 Riley Hospital Dr, Rr 208, Indianapolis, IN 46202-5109 | 2012-02-08 |
| Street Address |
4586 E HIGHWAY 20 SUITE B |
| City | NICEVILLE |
| State | FL |
| Zip Code | 32578-9724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124125505 | Steven Lester Clark | Family Medicine | 4586 E Highway 20, Suite B, Niceville, FL 32578-9724 | 2006-09-20 |
| 1356504799 | Lucy K Rice | Obstetrics & Gynecology | 4586 E Highway 20, Suite A, Niceville, FL 32578-9724 | 2008-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1497252860 | Molly Marie Everitt | Physician Assistant | 2190 Fl-85 N, Niceville, FL 32578 | 2018-04-11 |
| 1972009314 | Alexis Aust | Student in an Organized Health Care Education/Training Program | 104 Arrowhead Way, Niceville, FL 32578 | 2018-04-04 |
| 1518488949 | Michelle Sasala | Nurse Practitioner | 4550 E Highway 20, Niceville, FL 32578 | 2017-07-06 |
| 1003336199 | Comfortable Care Denta Health Professionals, Pa | Dentist | 1386 E John Sims Parkway, Niceville, FL 32578 | 2017-06-21 |
| 1306223888 | Emerald Coast Periodontics | Dentist | 719 Bayshore Drive, Niceville, FL 32578 | 2015-05-04 |
| 1538586136 | Pamela Ottesen Dmd LLC | Dentist | 1536 John Sims Pkwy, Niceville, FL 32578 | 2014-03-21 |
| 1417204066 | Mary Jo Stiles | Hearing Instrument Specialist | 4400 Hwy, 20 East, Suite # 211, Niceville, FL 32578 | 2012-08-13 |
| 1093086563 | Pat T. Tidwell Md Pa | Clinic/Center | 4554 Highway 20 East, Niceville, FL 32578 | 2012-01-16 |
| 1952683260 | Gentle Birth Options, LLC | Nurse Practitioner | 296 Bayshore Drive, Niceville, FL 32578 | 2011-09-13 |
| Find all providers in zip 32578 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598238263 | April R Pretz | Family Medicine | 812 Saint Kitts Cv, Niceville, FL 32578-3816 | 2019-01-06 |
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1316472368 | Terence B Mitchell Md Inc | Family Medicine | 2600 Partin Dr N Ste 300, Suite 330, Niceville, FL 32578-1543 | 2017-04-27 |
| 1184036725 | Julie Staats Do Family Medicine Pa | Family Medicine | 2600 Partin Dr N Ste 120, Niceville, FL 32578-1543 | 2014-06-02 |
| 1942488432 | Southland Emergency Medical Services of Fl Pl | Family Medicine | 1706 15th St, Niceville, FL 32578-3677 | 2008-02-06 |
| 1184758526 | Pat Thomas Tidwell | Family Medicine | 4400 E Highway 20 Ste 203, Niceville, FL 32578-7700 | 2007-03-16 |
| 1881752616 | Eduardo Luis Gonzalez | Family Medicine | 4400 E Highway 20 Ste 209, Niceville, FL 32578-7700 | 2006-12-05 |
| 1124125505 | Steven Lester Clark | Family Medicine | 4586 E Highway 20, Suite B, Niceville, FL 32578-9724 | 2006-09-20 |
| 1861456592 | Terence Burrell Mitchell | Family Medicine | 2600 Partin Dr N Ste 330, Niceville, FL 32578-1542 | 2006-04-12 |
| 1679546675 | Swati Nigam Grover | Family Medicine | 1065 Napa Way, Niceville, FL 32578-3960 | 2006-02-09 |
| Find all providers in NICEVILLE | ||||
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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.