Daphne Russ Green, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Bladenboro, North Carolina. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is
305 South Main Street, Bladenboro, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 770-1514.
Daphne Russ Green is licensed to practice in North Carolina (license number 5014060) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1255917746.
Provider's Profile
| Full Name | Daphne Russ Green |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 305 South Main Street, Bladenboro, North Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Daphne Russ Green graduated from nursing school in 2020
NPI Data:
- NPI Number: 1255917746
- Provider Enumeration Date: 03/23/2021
- Last Update Date: 05/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 9436550191
- Enrollment ID: I20210701001936
Medical Identifiers
Medical identifiers for Daphne Russ Green such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255917746 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 5014060 (North Carolina) | Primary |
Medical Facilities Affiliation
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Daphne Russ Green allows following entities to bill medicare on her behalf.
| Entity Name | Victory Medical Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356917793
PECOS PAC ID: 8527469287
Enrollment ID: O20210701001862 |
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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. Daphne Russ Green 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 Address | Practice Location Address |
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Daphne Russ Green, NURSE PRACTITIONER
305 South Main Street,
Bladenboro, NC 28320
Ph: (910) 809-0082 | Daphne Russ Green, NURSE PRACTITIONER
305 South Main Street,
Bladenboro, NC 28320
Ph: (910) 770-1514 |
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