DR. ERICK JOSEPH GREEN JR. (NPI# 1821371022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821371022 |
| Entity Type | Individual |
| Full Name | DR. ERICK JOSEPH GREEN JR. |
| Credential | MD |
| Practice Address |
2021 Herndon Ave # 101 Clovis CA 93611-6101 |
| Mailing Address |
7471 N Fresno St Fresno CA 93720-2457 |
| Practice Telephone | 5597974315 |
| Mailing Telephone | 5594364500 |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2017-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A130378 | CA | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
A130378 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760974836 | Erick Lamont Green | Case Manager/Care Coordinator | 5445 Laurel Hills Dr, Sacramento, CA 95841 | 2018-06-04 |
| Street Address |
2021 HERNDON AVE # 101 |
| City | CLOVIS |
| State | CA |
| Zip Code | 93611-6101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309688 | Kyrian C Obidiegwu | Physician Assistant | 2021 Herndon Ave # 101, Clovis, CA 93611-6316 | 2020-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773122 | Mao Thao | Pharmacist | 2133 Shaw Avenue, Clovis, CA 93611 | 2019-04-24 |
| 1326506098 | Lauren Moriah Horsley | Speech-Language Pathologist | 650 W. Alluvial Ave., Clovis, CA 93611 | 2019-03-12 |
| 1780171223 | Alamos Care | Skilled Nursing Facility | 2193 Alamos Ave, Clovis, CA 93611 | 2018-04-19 |
| 1346612215 | Aimee Rasch | Occupational Therapy Assistant | 650 West Alluvial Avenue, Clovis, CA 93611 | 2015-10-30 |
| 1356778302 | Jonathan Crosby | Physician Assistant | 729 N Medical Center Drive West Suite 101, Clovis, CA 93611 | 2013-10-07 |
| 1093142697 | Stacey Melissa Montes | Nurse Practitioner | 729 N Medical Ctr Dr West, Suite 205, Clovis, CA 93611 | 2013-09-27 |
| 1538594163 | Carly Bren Lepp | Physician Assistant | 2006 Shaw Avenue, Clovis, CA 93611 | 2013-09-13 |
| 1811246150 | Vishal Arya | Pharmacist | 2518 Austin Ave, Clovis, CA 93611 | 2012-08-31 |
| 1669757209 | Kiran V Atwal | Pharmacist | 1815 Herndon Ave--walgreens, Clovis, CA 93611 | 2011-10-14 |
| 1952615957 | Weight Away | Nutritionist | 1895 Herndon Ave, Suite 105, Clovis, CA 93611 | 2010-08-02 |
| Find all providers in zip 93611 | ||||
| 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 |
|---|---|---|---|---|
| 1225660871 | Mercy Seyi Ayodele | Family Medicine | 55 Shaw Ave Ste 207, Clovis, CA 93612-3819 | 2020-02-11 |
| 1932671005 | Jennifer Lynn Marmolejo | Family Medicine | 2552 Richert Ave, Clovis, CA 93611-6014 | 2018-12-29 |
| 1396210563 | Green Sports Medicine Inc | Family Medicine | 2021 Herndon Ave Ste 201, Clovis, CA 93611-6101 | 2018-10-03 |
| 1023429412 | Nadia Javaid | Family Medicine | 2006 Shaw Ave Ste 101, Clovis, CA 93611-4192 | 2014-05-19 |
| 1760667133 | Larry Lowry | Family Medicine | 208 Sandzen Dr, Clovis, NM 88101-2310 | 2008-01-04 |
| 1265620728 | Gurdaver Singh Dhaliwal | Family Medicine | 1555 Shaw Ave, Ste 101, Clovis, CA 93611-4096 | 2007-10-10 |
| 1225250087 | G&j Roth Prof Corp. | Family Medicine | 255 W Bullard Ave Ste 102, Clovis, CA 93612-0861 | 2007-05-02 |
| 1023231057 | Meenakshi Dhingra | Family Medicine | 2740 Herndon Ave, Clovis, CA 93611-6813 | 2007-04-10 |
| 1588789788 | Anthony W Montana | Family Medicine | 688 Medical Center Dr E Ste 104, Clovis, CA 93611-6807 | 2007-03-20 |
| 1356401830 | Clovis Family Healthcare | Family Medicine | 912 W 21st St, Clovis, NM 88101 | 2006-12-12 |
| Find all providers in CLOVIS | ||||
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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.