SHANNON GREEN (NPI# 1992772073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992772073 |
| Entity Type | Individual |
| Full Name | SHANNON GREEN |
| Credential | APRN |
| Practice Address |
2 Innovation Drive Suite 140 Greenville SC 29605-5263 |
| Mailing Address |
2 Innovation Drive Suite 140 Greenville SC 29607-5263 |
| Practice Telephone | 8642951750 |
| Practice Fax Number | 8642951753 |
| Mailing Telephone | 8642951750 |
| Mailing Fax Number | 8642951753 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2011-11-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2699 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194245969 | Shannon Laray Green | Counselor | 3800 Dalecrest Dr Unit 2109, Las Vegas, NV 89129-1769 | 2017-06-22 |
| 1760910079 | Shannon Green | Social Worker | 401 Whitney Ave Ste 320, Gretna, LA 70056-2502 | 2017-05-31 |
| 1942434295 | Shannon Green | Licensed Practical Nurse | 821 N Main Rd Apt 45a, Vineland, NJ 08360-8219 | 2009-05-14 |
| 1720254261 | Shannon Becker Green | Obstetrics & Gynecology | 5215 Loughoro Road Nw, Suite 500, Washington, DC 20016-2633 | 2008-05-05 |
| 1609070572 | Shannon Green | Marriage & Family Therapist | 1055 El Camino Dr, F-100, Costa Mesa, CA 92626-5574 | 2007-06-13 |
| 1164573275 | Shannon Green | Nutritionist | 1011 Ingleside Ave, Catonsville, MD 21228-1318 | 2007-01-15 |
| 1750995270 | Shannon Marie Green | Nurse Practitioner | 1 Hospital Dr, Columbia, MO 65212-1001 | 2020-09-02 |
| 1427618412 | Shannon Green | Behavior Technician | 1508 W Artesia Sq Apt B, Gardena, CA 90248-4773 | 2019-06-20 |
| 1811550999 | Shannon Green | Student in an Organized Health Care Education/Training Program | 112 Squire Hall, Buffalo, NY 14214-8006 | 2019-04-15 |
| 1528588605 | Shannon J Green | Chiropractor | 636 W Broadway St, North Little Rock, AR 72114-5526 | 2017-06-21 |
| Street Address |
2 INNOVATION DRIVE SUITE 140 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-5263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659307007 | Stephen Harris Keiser | Family Medicine | 2 Innovation Drive, Suite 250, Greenville, SC 29607 | 2006-06-25 |
| 1265490684 | Matthew G. Nessmith | Internal Medicine | 2 Innovation Drive, Suite 400, Greenville, SC 29607-5261 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482280 | Deanna Mclamb | Nurse Practitioner | 3102 Bell Arthur Rd, Greenville, NC 27834-4758 | 2020-09-19 |
| 1801401252 | Jodi Lynn Tesch | Nurse Practitioner | N984 Glennview Dr, Greenville, WI 54942-8531 | 2020-09-12 |
| 1760091482 | Melinda Kathryn Galford | Nurse Practitioner | 320 Falls St Apt 303, Greenville, SC 29601-2830 | 2020-07-28 |
| 1801414750 | Christopher Mangus | Nurse Practitioner | 1806 E 1st St Apt R9, Greenville, NC 27858-2214 | 2020-07-08 |
| 1932751559 | Caroline Gray Riddick | Nurse Practitioner | 527 Mills Ave # 201a, Greenville, SC 29605-5602 | 2019-07-13 |
| 1437621323 | Queeneice Boyette Ganison | Nurse Practitioner | 205 S Delta St, Greenville, MS 38703-4420 | 2018-12-18 |
| 1881169662 | Gerald Braden Wiggs | Nurse Practitioner | 3023 Fernleaf Dr, Greenville, NC 27858-8192 | 2018-10-09 |
| 1073091286 | Natalie Isbell Ragsdale | Nurse Practitioner | 20 Mcgee St, Greenville, SC 29601-2210 | 2018-07-31 |
| 1760980908 | Angela Nicole Gary | Nurse Practitioner | 1003 Grove Rd Ste C2, Greenville, SC 29605-4623 | 2018-01-23 |
| 1023527934 | Jennifer Anne Hovis | Nurse Practitioner | Hcr 2 5355, Greenville, MO 63944 | 2017-09-22 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29605 |
Please comment or provide details below to improve the information on SHANNON GREEN.
| 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.