ADAM S GREEN (NPI# 1750804050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750804050 |
| Entity Type | Individual |
| Full Name | ADAM S GREEN |
| Practice Address |
159 Trout Ave Groton CT 06340 |
| Mailing Address |
88 Buckeye Rd Groton CT 06340 |
| Practice Telephone | 6612031325 |
| Mailing Telephone | 6612031325 |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2017-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942664453 | Adam Hayes Green | Student in an Organized Health Care Education/Training Program | 2804 Lakeshore Dr, Ruston, LA 71270-2424 | 2016-04-11 |
| 1366466278 | Adam S Green | Physical Therapist | 467 Boulevard, Kenilworth, NJ 07033-1664 | 2006-07-26 |
| 1881692127 | Adam Wayne Green | Chiropractor | 2710 Broadway Extension, Parkersburg, WV 26101-6856 | 2005-07-11 |
| 1346732492 | Adam M Green | Orthopaedic Surgery | 28050 Grand River Ave, Farmington Hills, MI 48336-5919 | 2018-06-05 |
| 1679936462 | Adam W. Green | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2016-03-30 |
| 1558794768 | Adam Adair Green | Marriage & Family Therapist | 5698 W Glen Eagle Dr, West Valley City, UT 84128-4013 | 2013-08-12 |
| 1871882258 | Adam Godfrey Green | Internal Medicine | 1 Cooper Plz, Camden, NJ 08103-1461 | 2011-04-06 |
| 1861620213 | Adam W. Green | Anesthesiology | 2710 S Rife Medical Ln, Rogers, AR 72758-1452 | 2009-06-24 |
| 1417003039 | Adam L. Green | Pediatrics | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2007-01-26 |
| 1801946975 | Adam Stanley Green | Internal Medicine | 1055 N 500 W, #112 Bldg C, Provo, UT 84604-3305 | 2007-01-11 |
| Street Address |
159 TROUT AVE |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285699488 | Randy L Panke | Physician Assistant | 159 Trout Ave, Navsubase Nlon, Groton, CT 06349-5159 | 2006-04-19 |
| 1609416189 | Russell Jennings Rider | Military Health Care Provider | 159 Trout Ave, Groton, CT 06340 | 2020-01-13 |
| 1144715350 | Robert James Jones | Military Health Care Provider | 159 Trout Ave, Groton, CT 06349 | 2018-06-29 |
| 1033604244 | Brent Deangelo Hammond | Military Health Care Provider | 159 Trout Ave, Groton, CT 06349 | 2018-06-29 |
| 1790208882 | George Charles Fricke | Military Health Care Provider | 159 Trout Ave, Groton, CT 06340-0634 | 2017-07-20 |
| 1205359494 | Joseph Lampert | Military Health Care Provider | 159 Trout Ave, Groton, CT 04360 | 2017-07-20 |
| 1932622230 | Anthony J Gervasi | Military Health Care Provider | 159 Trout Ave, Groton, CT 06340 | 2017-07-19 |
| 1396268595 | Andrew Azevedo | Military Health Care Provider | 159 Trout Ave, Groton, CT 06340 | 2017-07-19 |
| 1184160483 | Michael Dean Couch | Military Health Care Provider | 159 Trout Ave, Groton, CT 06349-5159 | 2017-01-10 |
| 1376918466 | Austin Beaudean Lenzi | Military Health Care Provider | 159 Trout Ave, Groton, CT 06340-9321 | 2015-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052819 | Kenny Daniel Harp | Military Health Care Provider | 59 Deerwood Dr, Groton, CT 06340-2513 | 2020-01-09 |
| 1982244737 | Lonnie Jay Reardon | Military Health Care Provider | 55 South Rd Apt 12c, Groton, CT 06340-4660 | 2020-01-09 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1679132112 | Hector Salvador Gonzalez | Military Health Care Provider | 2 Bushnell St, Groton, CT 06340-3306 | 2019-06-09 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1558929026 | Joshua Darren Savage | Military Health Care Provider | 35 Chrissos St, Groton, CT 06340-3307 | 2019-05-30 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1992241228 | Phillip Lawernce Hardy Sr. | Military Health Care Provider | 123 Trout Ave, Naval Undersea Medical Institiute, Groton, CT 06340-5159 | 2017-01-10 |
| Find all providers in GROTON | ||||
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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.