KRISTINA RENAE GREENE (NPI# 1609879782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609879782 |
| Entity Type | Individual |
| Full Name | KRISTINA RENAE GREENE |
| Credential | PA-C |
| Practice Address |
980 Professional Park Dr Suite A Clarksville TN 37040-5251 |
| Mailing Address |
3024 Business Park Cir Goodlettsville TN 37072-3132 |
| Practice Telephone | 9319051001 |
| Practice Fax Number | 9319050410 |
| Mailing Telephone | 6158516033 |
| Mailing Fax Number | 6152969935 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2015-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA840 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MEDICARE RAILROAD | P00433226 | 01 |
| TN | 3667492 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841673449 | Kristina Greene | Dietitian, Registered | 303 E 89th Ave, Merrillville, IN 46410-8126 | 2015-07-01 |
| Street Address |
980 PROFESSIONAL PARK DR SUITE A |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37040-5251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780123679 | Middle Tennessee Imaging, LLC | Clinic/Center | 980 Professional Park Dr, Suite E, Clarksville, TN 37040-5251 | 2017-02-13 |
| 1326407024 | Amelia Wilson | Physical Therapist | 980 Professional Park Dr, Clarksville, TN 37040-5251 | 2016-02-23 |
| 1013373141 | Inessa Pavlovna Chernish | Physician Assistant | 980 Professional Park Dr, Suite A, Clarksville, TN 37040-5251 | 2016-01-05 |
| 1053789149 | Rebecca D Derby | Nurse Practitioner | 980 Professional Park Dr, Ste. C, Clarksville, TN 37040-5251 | 2015-09-08 |
| 1710360706 | Advanced Diagnostic Imaging PC | Durable Medical Equipment & Medical Supplies | 980 Professional Park Dr, Suite A, Clarksville, TN 37040-5251 | 2015-07-08 |
| 1831597806 | Middle Tennessee Imaging, LLC | Clinic/Center | 980 Professional Park Dr, Suite E, Clarksville, TN 37040-5251 | 2014-12-08 |
| 1114320108 | Pain Md LLC | Durable Medical Equipment & Medical Supplies | 980 Professional Park Dr, Ste. C, Clarksville, TN 37040-5251 | 2014-10-03 |
| 1174937320 | Daisy Tambe | Nurse Anesthetist, Certified Registered | 980 Professional Park Dr, Ste C, Clarksville, TN 37040-5251 | 2014-06-16 |
| 1447594486 | Amanda Jean Fryer | Nurse Practitioner | 980 Professional Park Dr, Ste. C, Clarksville, TN 37040-5251 | 2012-11-15 |
| 1316200454 | Charity Elizabeth Winters | Physical Therapist | 980 Professional Park Dr, Suite D, Clarksville, TN 37040-5251 | 2012-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124380 | Clarksville Treatment Center, LLC | Clinic/Center | 495 Dunlop Lane, Clarksville, TN 37040 | 2019-10-04 |
| 1295384956 | Dena Marie Borchick | Technician | 3779 Cindy Jo Dr. N, Clarksville, TN 37040 | 2019-09-05 |
| 1477014488 | Emily Allen | Dentist | 930 Hwy 76, Clarksville, TN 37040 | 2019-03-31 |
| 1730640566 | Latoya Ewert | Counselor | Centerstone Clarksville Harriet Cohn Center, 511 8th Street, Clarksville, TN 37040 | 2019-03-26 |
| 1356811988 | Jamie Coles | Behavior Technician | 851 Professional Park Drive 851 Profesiional Park Drive, Clarksville, TN 37040 | 2018-11-27 |
| 1518448554 | Bandel Counseling Service | Clinic/Center | 113 3rd St., Suite 25, Clarksville, TN 37040 | 2018-08-28 |
| 1477052520 | Bridget Stokes | Behavior Technician | 2277 Wilma Rudolph Blvd., Suite C #259, Clarksville, TN 37040 | 2018-02-05 |
| 1053824334 | Sandra Loren Coates | Nurse Practitioner | 980 Professional Park Dr Ste C, Clarksville, TN 37040 | 2017-11-09 |
| 1902328362 | Terri Brooke Roach | Registered Nurse | 651 Dunlop Lane, Clarksville, TN 37040 | 2017-07-07 |
| 1093244428 | Nikkia Deneil Bell | Behavior Technician | 139 E. Old Trenton Rd, Suite B, Clarksville, TN 37040 | 2017-06-08 |
| Find all providers in zip 37040 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407472079 | Melissa Perkins | Physician Assistant | 2080 Madison St, Clarksville, TN 37043-5087 | 2020-06-19 |
| 1932735297 | Desirae Marie Sheppard | Physician Assistant | 1304 Sharptail Trl, Clarksville, TN 37042-8113 | 2020-03-19 |
| 1669011094 | Jasmine Adams | Physician Assistant | 609 Rocky Hill Rd, Clarksville, TN 37042-6019 | 2020-01-02 |
| 1700369394 | Michael English | Physician Assistant | 1871 Rains Rd, Clarksville, TN 37042-1966 | 2018-09-11 |
| 1770078040 | Novus Behavioral Health | Physician Assistant | 130 Hillcrest Dr Ste 213, Clarksville, TN 37043-5083 | 2018-06-28 |
| 1619462546 | Cody R Thomas | Physician Assistant | 1060 W Creek Coyote Trl Apt 1302, Clarksville, TN 37042-8266 | 2018-06-23 |
| 1447753314 | Vincent Michael Proctor | Physician Assistant | 775f Weatherly Dr, Clarksville, TN 37043-8942 | 2018-03-16 |
| 1124539580 | Lauren Michelle Huddleston | Physician Assistant | 1524 Madison St, Clarksville, TN 37040-3846 | 2017-10-12 |
| 1043720287 | Kathryn Fitzpatrick Rodgers | Physician Assistant | 5403 Talon Ct, Clarksville, MD 21029-1142 | 2017-10-02 |
| 1194243709 | Christina Joanne O'hara-rodriguez | Physician Assistant | 803 River Run, Clarksville, TN 37043-6042 | 2017-09-03 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 37040 |
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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.