NPI age
20 years
Enumerated 2006-03-14
● Active
Type 1 · Individual
Johnny Bert Green, MD
Green is 1 of 8 colon & rectal surgery providers in Boise and 1 of 8 in Idaho.
Primary specialty
Colon & Rectal Surgery
Plus 2 subspecialties
Licensed in
ID, WA
2 states
Status
Active
No deactivations on record
Last NPPES update
2016-11-15
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 8 active colon & rectal surgery providers in Idaho.
NPI age
20 years
↑ 3 yr above median (17 yr)
State licenses
2 states
Top 62% — 37% of peers are multi-state
Subspecialties
1
In the 87% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-03Enumerated in NPPES
2006
2026
Where they practice
Practice location
1072 N Liberty Street, Suite 201
Boise, ID 83704
Mailing address
3340 E Goldstone Way
Meridian, ID 836421026
Specialties
-
Colon & Rectal Surgery PrimaryA colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues...
-
SurgeryA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1386612414 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.