DR. MARK ELLISON GREEN (NPI# 1154395044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154395044 |
| Entity Type | Individual |
| Full Name | DR. MARK ELLISON GREEN |
| Credential | M.D. |
| Practice Address |
370 Bmh Physicians Office Bldg Maryville TN 37804-5819 |
| Mailing Address |
103 W Broadway Ave Maryville TN 37801-4703 |
| Practice Telephone | 8659805360 |
| Practice Fax Number | 8659805356 |
| Mailing Telephone | 8652731752 |
| Mailing Fax Number | 8652731755 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD0000017438 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1526169 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902342165 | Mark Green | Specialist/Technologist | 339 Nacoochee Dr, Rabun Gap, GA 30568-2200 | 2017-01-12 |
| 1215293261 | Mark S Green | Pharmacist | 923 W Central Park Ave, Davenport, IA 52804-1802 | 2012-04-04 |
| 1811123862 | Mark Ryan Green | Physical Therapist | 29185 Highway 191, Many, LA 71449-6313 | 2009-06-04 |
| 1770785925 | Mark Daniel Green | Dentist | 415 1st St E, Humble, TX 77338-4602 | 2007-06-01 |
| 1386760981 | Mark R Green | Dentist | 108 Vail St, Middlesex, NJ 08846-1943 | 2007-03-22 |
| 1609968544 | Mark Allen Green | Chiropractor | 2137 Dixie Hwy, Louisville, KY 40210-2242 | 2006-09-28 |
| 1841209962 | Mark Raymond Green | Dentist | 2201 Lincoln Way West, South Bend, IN 46628-2513 | 2006-08-07 |
| 1396736336 | Mark S Green | Physician Assistant | 10040 Two Notch Rd, Columbia, SC 29223-4396 | 2005-10-31 |
| 1083162424 | Mark Green | Pharmacist | 731 Cherry Dr, Hershey, PA 17033-2099 | 2016-09-14 |
| 1033589569 | Mark Stephen Green | Psychologist | 9415 E Harry St, Suite 703, Wichita, KS 67207-5089 | 2015-09-26 |
| Street Address |
370 BMH PHYSICIANS OFFICE BLDG |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831572296 | Benjamin Blodgett | Podiatrist | 370 Bmh Physicians Office Bldg, Maryville, TN 37804-5819 | 2015-07-02 |
| 1689774291 | Gina Lynn Bearden | Nurse Practitioner | 370 Bmh Physicians Office Bldg, Maryville, TN 37804-5819 | 2006-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669737706 | Vamsi Nukala | Internal Medicine | 2090 Vadalabene Dr Ste 1, Maryville, IL 62062-5841 | 2012-07-04 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1609912054 | Carole Louise Long | Internal Medicine | 2036 Chilhowee Professional Park, Maryville, TN 37804-5285 | 2007-01-30 |
| 1790862803 | Ibrahim F Shalaby | Internal Medicine | 463 Bmh Physician Office Bldg, Maryville, TN 37804-5807 | 2006-11-01 |
| 1912084096 | Komal H Kirpekar | Internal Medicine | 365 Bmh Physicians Office Bldg, Maryville, TN 37804-5820 | 2006-11-01 |
| 1952332918 | Tibor Charles Kopjas | Internal Medicine | 2118 Vadalabene Dr, Maryville, IL 62062-5632 | 2006-07-06 |
| 1891721379 | Kim H Cline | Internal Medicine | 111 Station Dr, Maryville, TN 37804-4190 | 2006-06-25 |
| 1558307181 | David Allan Cox | Internal Medicine | 1131 E Lamar Alexander Pkwy, Maryville, TN 37804-5130 | 2006-06-21 |
| 1225078454 | Joseph Duane Payne | Internal Medicine | 1103 E. Lamar Alexander Pkwy, Maryville, TN 37804 | 2006-06-07 |
| Find all providers in MARYVILLE | ||||
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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.