RANDALL W. GREEN MD PC (NPI# 1538489828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538489828 |
| Entity Type | Organization |
| Organization Name | RANDALL W. GREEN MD PC |
| Practice Address |
4070 Lake Dr Se Ste 201 Grand Rapids MI 49546-8294 |
| Practice Telephone | 6167748200 |
| Practice Fax Number | 6167740304 |
| Mailing Telephone | 6167748200 |
| Mailing Fax Number | 6167740304 |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |
| Authorized Official Name | DR. RANDALL WILLIAM GREEN (PRESIDENT) |
| Authorized Official Telephone | 6167748200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1073594 | 05 |
| Street Address |
4070 LAKE DR SE STE 201 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| 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 |
|---|---|---|---|---|
| 1972098242 | Iman Qaiser | Internal Medicine | 200 Jefferson Ave Se Bldg Ste 305, Grand Rapids, MI 49503-4502 | 2018-06-28 |
| 1477048437 | Angelea Young Heider | Internal Medicine | 25 Michigan St Ne Ste 210, Grand Rapids, MI 49503-2515 | 2018-06-22 |
| 1386165942 | Sheda Monfared Beheshti | Internal Medicine | 300 Lafayette Ave Se Ste 3000, Grand Rapids, MI 49503-4692 | 2017-07-03 |
| 1831571389 | David Bryska | Internal Medicine | 300 Lafayette Ave Se # 3000, Grand Rapids, MI 49503-4692 | 2015-06-22 |
| 1104238484 | Andrea Landon | Internal Medicine | 2144 E Paris Ave Se # 200, Grand Rapids, MI 49546-6111 | 2014-05-21 |
| 1669813259 | Ruchira Sengupta | Internal Medicine | 100 Michigan St Ne # Mc031, Grand Rapids, MI 49503-2560 | 2013-07-10 |
| 1740595735 | Anas Ahmad | Internal Medicine | 1959 East Paris Ave S.e., Grand Rapids, MI 49546 | 2010-08-13 |
| 1871805895 | Spectrum Health Primary Care Partners | Internal Medicine | 4444 Kalamazoo Ave Sw, Suite 200, Grand Rapids, MI 49508 | 2010-07-07 |
| 1114120771 | David Chi Ming Shen | Internal Medicine | 310 Lafayette Se, Ste 415, Grand Rapids, MI 49503 | 2007-06-08 |
| 1962610469 | Sara H Mccune | Internal Medicine | 1545 68th St Se Suite 100, Grand Rapids, MI 49508-5609 | 2007-05-18 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.