Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Randall Devin Green Jr., FNP-C, RN, AE-C, CPN

Individual provider Family Nurse Practitioner · NPI 1295540821

Mr. Randall Devin Green Jr., FNP-C, RN, AE-C, CPN is a Nurse Practitioner in Roanoke, Virginia. Qualified in 2025, 1 year ago. Practices with Minuteclinic Diagnostic of Virginia LLC, a 141-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2025
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

2001 Colonial Ave SW
Roanoke, VA 24015-3210
Phone: (866) 389-2727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0024194196 (VA)

Record details

NPI number1295540821
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C , RN , AE-C , CPN
Sole proprietorNo
NPI enumeratedFebruary 11, 2025
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Minuteclinic Diagnostic Of Virginia Llc — 141 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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