CMS-1500 Box 24J / 33a • NPI
1831178755
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207Q00000X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
1200 S FARMERVILLE ST, RUSTON, LA, 71270-5941
✓ 9-Digit EDI 837 ZIP+4 (71270-5941)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1831178755 (GREEN CLINIC LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1831178755 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | GREEN CLINIC LLC |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207Q00000X (Family Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 1200 S FARMERVILLE ST, RUSTON, LA, 71270-5941 |
| Practice Telephone / Fax | Tel: (318) 255-3690 |
| Administrative Mailing Address | 1200 S FARMERVILLE ST, RUSTON, LA, 71270-5941 |
| Enumeration & Last Sync | Enumerated: 2006-01-10 | CMS Record Updated: 2026-10-22 |
| Authorized Official | CLAYTON NORMAN (Administrator) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)
What Does Taxonomy Code 207Q00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (GREEN CLINIC LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
133V00000X — Dietitian, RegisteredPlain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered | State: N/A | License: Verified | Primary: Secondary |
204C00000X — Neuromusculoskeletal Medicine, Sports MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Neuromusculoskeletal Medicine, Sports Medicine | State: N/A | License: Verified | Primary: Secondary |
204E00000X — Oral & Maxillofacial SurgeryPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery | State: N/A | License: Verified | Primary: Secondary |
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: N/A | License: Verified | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Yes (Primary) |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207U00000X — Nuclear MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Nuclear Medicine | State: N/A | License: Verified | Primary: Secondary |
207V00000X — Obstetrics & GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: N/A | License: Verified | Primary: Secondary |
207W00000X — OphthalmologyPlain English: Board-Certified in Ophthalmology (Medical & Microsurgical Eye Doctor) | State: N/A | License: Verified | Primary: Secondary |
207X00000X — Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207Y00000X — OtolaryngologyPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology | State: N/A | License: Verified | Primary: Secondary |
208000000X — PediatricsPlain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) | State: N/A | License: Verified | Primary: Secondary |
208100000X — Physical Medicine & RehabilitationPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation | State: N/A | License: Verified | Primary: Secondary |
2083P0500X — Preventive Medicine, Preventive Medicine/Occupational Environmental MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Preventive Medicine — Occupational Environmental Medicine | State: N/A | License: Verified | Primary: Secondary |
213E00000X — PodiatristPlain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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