| Dora Renee Green, CRNA | |
|
2600 Greenbush St, Lafayette, IN 47904-2477 | |
| (765) 448-8000 | |
| Not Available |
| Full Name | Dora Renee Green |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 25 Years |
| Location | 2600 Greenbush St, Lafayette, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245217124 | NPI | - | NPPES |
| 2247661 | Medicaid | OH | |
| 728022 | Other | BUCKEYE | |
| 74006495 | Medicaid | KY | |
| 000001092366 | Other | IN | ANTHEM PROVIDER NUMBER |
| 000000196948 | Other | ANTHEM BLUE SHIELD | |
| 300004136 | Medicaid | IN | |
| 617576 | Other | KY | WELLCARE |
| 200371350 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209.013944 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southwest Ohio Anesthesia Consultants Llc | 6901700640 | 331 |
| Entity Name | Southwest Ohio Anesthesia Consultants Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588645188 PECOS PAC ID: 6901700640 Enrollment ID: O20031124000399 |
| Entity Name | Outpatient Anesthesia Specialists |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891976643 PECOS PAC ID: 1456431162 Enrollment ID: O20080108000408 |
| Mailing Address | Practice Location Address |
|---|---|
| Dora Renee Green, CRNA 19624 Governors Hwy, Suite 6 & 7, Flossmoor, IL 60422-2077 Ph: (708) 798-5838 | Dora Renee Green, CRNA 2600 Greenbush St, Lafayette, IN 47904-2477 Ph: (765) 448-8000 |
Roger E. Brown, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Rhiannon H Mccarty, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Autumn M Swann, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 | |
James M Mclaughlin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-838-4758 | |
Jeffrey Hood, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 | |
Brianne Nicole Caniglia, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 |