NPI age
5 years
Enumerated 2021-03-24
● Active
Type 1 · Individual
Brooklyn Walsh Green, PA-C
Green is 1 of 36 physician assistant providers in Thomasville and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
GA, FL
2 states
Status
Active
No deactivations on record
Last NPPES update
2024-04-20
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
5 years
↓ 3 yr below median (8 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
0
24% of peers hold subspecialties
NPI lifetime · 2021 → 2026
2021-03Enumerated in NPPES
2021
2026
Where they practice
Practice location
100 Mimosa Dr Fl 2
Thomasville, GA 317926676
Mailing address
100 Mimosa Dr Fl 2
Thomasville, GA 317926676
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (FL) | PA9114960 | FLORIDA MEDICAL LICENSE NO. |
| 01 (GA) | 12179 | GEORGIA MEDICAL LICENSE NO. |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new physician assistant provider has been added in Thomasville in the last 180 days.
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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.