CHARLES R GREEN (NPI# 1568499267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568499267 |
| Entity Type | Individual |
| Full Name | CHARLES R GREEN |
| Credential | MD |
| Practice Address |
612 N Andover Rd Andover KS 67002-9778 |
| Mailing Address |
Po Box 8035 Wichita KS 67208-0035 |
| Practice Telephone | 3167336618 |
| Practice Fax Number | 3167335299 |
| Mailing Telephone | 3166899135 |
| Mailing Fax Number | 3166899102 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2016-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 30255 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | 103199 | 01 | |
| KS | 100641000A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891285730 | Charles Green | Non-emergency Medical Transport (VAN) | 89 Hunt Ct Apt A, Columbia, SC 29206-5958 | 2018-05-16 |
| 1811266927 | Charles Perry Green | Community Health Worker | 3361 No Kid Rd, Kamiah, ID 83536-5002 | 2011-12-19 |
| 1336262559 | Charles Bruce Green | Family Medicine | Hq Usaf Sg, 1780 Air Force Pentagon, Washington, DC 20330-0001 | 2007-04-10 |
| 1588735146 | Charles Goodwin Green | Pharmacist | 221 S Midland Ave, Monroe, GA 30655-1629 | 2006-11-13 |
| 1073698189 | Charles Gary Green | Radiology | 60 Hall Street, Susanville, CA 96130 | 2006-10-26 |
| 1154801421 | Charles Green | Behavior Technician | 1819 E Springfield Ave Ste H, Spokane, WA 99202-2954 | 2018-08-16 |
| 1285110460 | Charles Jacob Green IIi | Social Worker | 2272 Collingwood Blvd, Toledo, OH 43620-1147 | 2018-07-11 |
| 1093226706 | Charles Levon Green | Counselor | 803 W 4th Street, Suite D, Pueblo, CO 81003 | 2017-10-20 |
| 1124471784 | Charles Green | Counselor | 684 Ellis St, San Francisco, CA 94109-8090 | 2016-07-19 |
| 1902127632 | Charles William Green | Nurse Practitioner | 500 Sentara Cir, Suite 102, Williamsburg, VA 23188-5727 | 2010-06-16 |
| Street Address |
612 N ANDOVER RD |
| City | ANDOVER |
| State | KS |
| Zip Code | 67002-9778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053372037 | Jill L Johnson-smith | Physician Assistant | 612 N Andover Rd, Andover, KS 67002-9778 | 2006-03-30 |
| 1386962215 | Tara Katz | Family Medicine | 612 N Andover Rd, Andover, KS 67002-9778 | 2010-05-17 |
| 1255340337 | Michael Wilson | Family Medicine | 612 N Andover Rd, Andover, KS 67002-9778 | 2006-08-06 |
| 1871525352 | Mary E Faragher | Nurse Practitioner | 612 N Andover Rd, Andover, KS 67002-9778 | 2006-07-07 |
| 1780611442 | Scott M Hane | Family Medicine | 612 N Andover Rd, Andover, KS 67002-9778 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386262707 | Rachel Marie Porter | Nurse Practitioner | Andover Family Medicine, 2117 N Keystone Circle, Andover, KS 67002 | 2020-07-13 |
| 1033535695 | Michael L Ray | Chiropractor | 1145 N Andover Rd Ste 109, Andover, KS 67002 | 2014-03-06 |
| 1225372949 | Lisa Hua Lee | Physical Therapy Assistant | 811 N Crescent Lakes Cir, Andover, KS 67002 | 2012-11-19 |
| 1689992752 | Andover Senior Care, LLC | Skilled Nursing Facility | 224 E Central Ave, Andover, KS 67002 | 2010-05-13 |
| 1033303136 | Casey T Hummel | Chiropractor | 550 North Andover Road, Andover, KS 67002 | 2007-08-31 |
| 1801007786 | Kansas Medical Center, LLC | Family Medicine | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
| 1205929957 | Sitha Uy Miller | Internal Medicine | 943 N. Andover Road, Andover, KS 67002 | 2006-10-02 |
| 1275644650 | Shala Renee Holman | Physician Assistant | 1124 W. 21st Street, Andover, KS 67002 | 2006-08-31 |
| 1497869168 | Allan Michael Weilert | Chiropractor | 202 E Rhondda St, Ste A, Andover, KS 67002 | 2006-08-18 |
| 1407872708 | Lindsay Marie Landers | Family Medicine | 105 S Andover Rd, Suite D, Andover, KS 67002 | 2006-07-14 |
| Find all providers in zip 67002 | ||||
| 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 |
|---|---|---|---|---|
| 1194088484 | Micah Hall | Family Medicine | 105 S Andover Rd Ste D, Andover, KS 67002-7926 | 2012-06-21 |
| 1962636944 | Kari R Clouse | Family Medicine | 307 W Hwy 54 Ste 300, Andover, KS 67002-7849 | 2009-05-06 |
| 1346434081 | Melissa Lynn Reilly | Family Medicine | 272 Route 206 North, Andover, NJ 07821 | 2007-09-05 |
| 1801007786 | Kansas Medical Center, LLC | Family Medicine | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
| 1407079973 | Marianne Shuchin Liu | Family Medicine | 13819 Hanson Blvd. Nw, Fair View Clinic, Andover, MN 55304 | 2007-04-11 |
| 1023143823 | Samuel J. Daisley D.o. Inc. | Family Medicine | 149 E Main St # 1117, Andover, OH 44003-9479 | 2007-02-22 |
| 1689722001 | Catherine R Trader | Family Medicine | 8 Lenape Road, Andover, NJ 07821 | 2007-01-08 |
| 1063512507 | Paresh K Thakkar | Family Medicine | 13 Wabanaki Way, Andover, MA 01810-5524 | 2006-09-24 |
| 1922017128 | William A Coch | Family Medicine | 20 S Main St., Andover, NY 14806 | 2006-08-05 |
| 1407872708 | Lindsay Marie Landers | Family Medicine | 105 S Andover Rd, Suite D, Andover, KS 67002 | 2006-07-14 |
| Find all providers in ANDOVER | ||||
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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.