Green'S Country Clinic, LLC
NPI 1093240749 · Medical Physician Assistant · Blackwell, OK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Green'S Country Clinic, LLC is a Medical Physician Assistant organization in Blackwell, OK (NPI 1093240749).
Provider details
- NPI number
- 1093240749
- Entity type
- Organization
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Phil Green, Physician Assistant(580) 363-0943
- License
- 800 (OK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-05-01
- Last updated
- 2017-05-01
Frequently asked questions
- What is Green'S Country Clinic, LLC's NPI number?
- Green'S Country Clinic, LLC's National Provider Identifier (NPI) is 1093240749, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Green'S Country Clinic, LLC?
- Green'S Country Clinic, LLC is classified in the NPPES registry as Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Green'S Country Clinic, LLC located?
- Green'S Country Clinic, LLC's practice location on file with NPPES is 223 E Blackwell Ave, Blackwell, OK 74631-2909.
- What is Green'S Country Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Green'S Country Clinic, LLC is (580) 363-0943.
- Does Green'S Country Clinic, LLC accept Medicare?
- Green'S Country Clinic, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Green'S Country Clinic, LLC?
- The authorized official listed on Green'S Country Clinic, LLC's NPPES record is Phil Green, Physician Assistant. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Green'S Country Clinic, LLC's NPI active?
- Yes — Green'S Country Clinic, LLC's NPI (1093240749) is active in the NPPES registry as of the last update on 2017-05-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.