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DR. KENNETH O GREEN M.D NPI 1780680900


NPI Information

NPI: 1780680900
Provider Name: DR. KENNETH O GREEN, M.D,
Classification: Ophthalmology - 207W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
111 W LINCOLN ST
BELLEVILLE, IL
ZIP 62220
Phone: (618) 234-1774
Get Directions

DR. Kenneth O Green, M.D, is an ophthalmology in Belleville, IL. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DR. Kenneth O Green, M.D, NPI is 1780680900. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 W LINCOLN ST
BELLEVILLE, IL
ZIP 62220-019
Phone: (618) 234-1774
Fax: (618) 234-7979

The NPI 1780680900 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2005 and was last updated on 4/13/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmology036037266ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11376586685OTHERILLINOISNPI GROUP
2C37410MEDICARE UPINILLINOIS
3211586OTHERILLINOISMEDICARE GROUP
4K17092MEDICARE PINILLINOIS
5554490MEDICARE PINILLINOIS
6CH6508OTHERILLINOISMEDICARE RAILROAD GROUP
7036037266MEDICAIDILLINOIS
8P00216102OTHERILLINOISMEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.