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Deactivated NPI 1164402863 Deactivated / Inactive NPI Female Practitioner

Dr. Lisa R Green , OD

Optometrist • Jemison, AL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Lisa Green has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 19, 2006
NPI Deactivation Date October 13, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Lisa Green, OD was a registered Optometrist practicing in Jemison, AL. Throughout an active medical career spanning 14 years, Dr. Green provided care at the practice location at 24810 US HIGHWAY 31 until profile deactivation on 2020-10-13.

Historical Medicare Part B clinical services included established patient complete exam of visual system, photography of the retina, new patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

24810 Us Highway 31

Jemison, AL 350857876

Telephone 2056881010
Fax 2056883802
Associated Practice Facility / Clinic
🏢 Jemison Eye Care Llc Facility NPI 1558403568

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Jemison, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Jemison, AL (907 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
17.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
49 49 $123.76 $113.36
92250 Photography of the retina
46 46 $90.00 $45.47
92004 New patient complete exam of visual system
40 40 $143.63 $133.49
99213 Established patient office or other outpatient visit, typically 15 minutes
16 13 $80.63 $68.83

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License AL S-A35-TA-588

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
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NPI Profile Deactivated October 13, 2020

Record deactivated on October 13, 2020

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Updated Practice Location October 15, 2019

Registered at 2400 HOSPITAL RD BLDG 3, TUSKEGEE, AL 36083 (Tel: 3347253346)

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Updated Business Mailing Address October 15, 2019

Registered at 2400 HOSPITAL RD BLDG 3, TUSKEGEE, AL 360835001 (Tel: 3347253346)

NPI Profile Active March 20, 2018

NPI status registered as active in NPPES database

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Updated Practice Location March 20, 2018

Registered at 300 TWINING ST BLDG 760, MONTGOMERY, AL 361126027 (Tel: 3349539748)

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Updated Business Mailing Address March 20, 2018

Registered at 300 TWINING ST BLDG 760, MONTGOMERY, AL 361126027

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Provider Name / Credentials Updated March 20, 2018

Recorded as LISA GREEN, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 20, 2018

Optometrist (License #S-A35-TA-588 in AL)

NPI Profile Active June 03, 2014

NPI status registered as active in NPPES database

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Updated Practice Location June 03, 2014

Registered at 24810 US HIGHWAY 31, JEMISON, AL 350857876 (Tel: 2056881010)

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Updated Business Mailing Address June 03, 2014

Registered at PO BOX 730, JEMISON, AL 350850730 (Tel: 2056881010)

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Provider Name / Credentials Updated June 03, 2014

Recorded as LISA GREEN, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2014

Optometrist (License #S-A35-TA-588 in AL)

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Initial NPI Registration & Enumeration January 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164402863
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 19, 2006
Last Update: June 03, 2014
Deactivation Date: October 13, 2020

Mailing Address

Po Box 730

Jemison, AL 350850730

Phone: 2056881010

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.