Green Clinic Llc - Medicare in Ruston, LA

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Green Clinic Llc is a medicare enrolled "Family Medicine" provider in Ruston, Louisiana. Their current practice location is 1200 S Farmerville St, Ruston, Louisiana. You can reach out to their office (for appointments etc.) via phone at (318) 255-3690.

Green Clinic Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Green Clinic Llc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1831178755.

Contact Information

Green Clinic Llc
1200 S Farmerville St,
Ruston, LA 71270-5941
(318) 255-3690
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameGreen Clinic Llc
TypeFacility
SpecialityFamily Medicine
Location1200 S Farmerville St, Ruston, Louisiana
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1831178755
  • Provider Enumeration Date: 01/10/2006
  • Last Update Date: 10/22/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 4789668831
  • Enrollment ID: O20040616000177

Medical Identifiers

Medical identifiers for Green Clinic Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1831178755NPI-NPPES
1006858MedicaidLA
CS0281OtherLARR MEDICARE GROUP
06185OtherLABCBS GROUP
=========OtherLABCBS GROUP

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered (* (Not Available))Secondary
204C00000XNeuromusculoskeletal Medicine, Sports Medicine (* (Not Available))Secondary
204E00000XOral & Maxillofacial Surgery (* (Not Available))Secondary
207N00000XDermatology (* (Not Available))Secondary
207Q00000XFamily Medicine (* (Not Available))Primary
207R00000XInternal Medicine (* (Not Available))Secondary
207U00000XNuclear Medicine (* (Not Available))Secondary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
207W00000XOphthalmology (* (Not Available))Secondary
207X00000XOrthopaedic Surgery (* (Not Available))Secondary
207Y00000XOtolaryngology (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
208100000XPhysical Medicine & Rehabilitation (* (Not Available))Secondary
2083P0500XPreventive Medicine - Preventive Medicine/occupational Environmental Medicine (* (Not Available))Secondary
213E00000XPodiatrist (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Green Clinic Llc acts as a billing entity for following providers:
Provider NameDerek R Mcclusky
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1184694903
PECOS PAC ID: 8426077470
Enrollment ID: I20051118000239
Provider NameKerry Byrnes
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1982787099
PECOS PAC ID: 2668574914
Enrollment ID: I20070216000567
Provider NameElvin Gregory Tubre
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1336108877
PECOS PAC ID: 8123015989
Enrollment ID: I20071217000732
Provider NameLandon C Smith
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1790783322
PECOS PAC ID: 5294894499
Enrollment ID: I20081103000391
Provider NameEdie Lemley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891711883
PECOS PAC ID: 1355496423
Enrollment ID: I20090826000544
Provider NameGeorge Smith
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1164492484
PECOS PAC ID: 0143300772
Enrollment ID: I20100210000374
Provider NameCandace Moak
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1588634273
PECOS PAC ID: 4981784519
Enrollment ID: I20100211000373
Provider NameWilliam Smith
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1992776231
PECOS PAC ID: 6406936038
Enrollment ID: I20100215000272
Provider NameMichael Ehrlich
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1780654186
PECOS PAC ID: 7517047145
Enrollment ID: I20100302000052
Provider NameMark Blackwelder
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1245200880
PECOS PAC ID: 0345320974
Enrollment ID: I20100303001150
Provider NameTarek M Nammour
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1689644379
PECOS PAC ID: 8820907462
Enrollment ID: I20100315001012
Provider NameGary Ellis Luffey
Provider TypePractitioner - Ophthalmology
Provider IdentifiersNPI Number: 1760452650
PECOS PAC ID: 0749207488
Enrollment ID: I20100315001015
Provider NameThomas Smith
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1801867130
PECOS PAC ID: 5597845123
Enrollment ID: I20100317000369
Provider NameRaymond D Germany Jr
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1649275116
PECOS PAC ID: 8628976255
Enrollment ID: I20100714000499
Provider NameAaron Marquardt
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1538349733
PECOS PAC ID: 7315129038
Enrollment ID: I20110316000598
Provider NameRobert Todd Rickman
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1417168782
PECOS PAC ID: 0042476418
Enrollment ID: I20120730000646
Provider NameKamal A Masri
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1134418437
PECOS PAC ID: 8022232305
Enrollment ID: I20150129001319
Provider NameAshley Walpole
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164804936
PECOS PAC ID: 9638485394
Enrollment ID: I20150826002274
Provider NameCleo Deason
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881077808
PECOS PAC ID: 8123334398
Enrollment ID: I20150902002006
Provider NameNavneet Sharma
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1811286099
PECOS PAC ID: 0547577934
Enrollment ID: I20150917000807
Provider NameKevin M Langlois
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1184997264
PECOS PAC ID: 6204145261
Enrollment ID: I20151014002501
Provider NameWesley Lee Coleman
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1124492137
PECOS PAC ID: 3870895303
Enrollment ID: I20151230001014
Provider NameMarlene Daher
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1952371965
PECOS PAC ID: 6608956230
Enrollment ID: I20160203000883
Provider NameRobin Renee Hart Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346612173
PECOS PAC ID: 4880998046
Enrollment ID: I20160209000215
Provider NameRobert Railey Garrett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992162622
PECOS PAC ID: 8820392681
Enrollment ID: I20160215002472
Provider NameStavan Y Patel
Provider TypePractitioner - Maxillofacial Surgery
Provider IdentifiersNPI Number: 1558688309
PECOS PAC ID: 6507161817
Enrollment ID: I20160721001012
Provider NameHollie A Knapp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710438668
PECOS PAC ID: 9335426105
Enrollment ID: I20170503002075
Provider NameJacob Elidge Enterkin
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1306043096
PECOS PAC ID: 2769626530
Enrollment ID: I20180123003151
Provider NameLisa Marie Farris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700385622
PECOS PAC ID: 8921369604
Enrollment ID: I20180220001480
Provider NameErin Lancaster
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104399393
PECOS PAC ID: 6901144500
Enrollment ID: I20190206001062
Provider NameKristina D Barber
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043801954
PECOS PAC ID: 2163838145
Enrollment ID: I20210317002215
Provider NameHunter Thomas Christy
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1699162206
PECOS PAC ID: 5698073211
Enrollment ID: I20210616002306
Provider NameHannah Rose Rugg
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1831758630
PECOS PAC ID: 0244662161
Enrollment ID: I20220726000254
Provider NameCynthia P Bimle
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1578573630
PECOS PAC ID: 8123403581
Enrollment ID: I20220921001445
Provider NameMichael Kyle Hendricks
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1205196805
PECOS PAC ID: 3072978147
Enrollment ID: I20230424002301
Provider NameTaylor Blake Boggs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437937125
PECOS PAC ID: 5991152670
Enrollment ID: I20231117001470
Provider NameThomas Iii Block
Provider TypePractitioner - Diagnostic Radiology
Provider IdentifiersNPI Number: 1265096390
PECOS PAC ID: 9537490883
Enrollment ID: I20240521001258
Provider NameCody Blackwelder
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1548824873
PECOS PAC ID: 1153716253
Enrollment ID: I20240710000011
Provider NameSarat Sabharwal
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1114983392
PECOS PAC ID: 9032007984
Enrollment ID: I20250108001022

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Green Clinic Llc is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Green Clinic Llc
1200 S Farmerville St,
Ruston, LA 71270-5941

Ph: (318) 255-3690		Green Clinic Llc
1200 S Farmerville St,
Ruston, LA 71270-5941

Ph: (318) 255-3690

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.