EBONY GREEN (NPI# 1285030486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285030486 |
| Entity Type | Individual |
| Full Name | EBONY GREEN |
| Practice Address |
19670 E Reins Rd Queen Creek AZ 85142 |
| Mailing Address |
137 E Mary Ln Gilbert AZ 85295-1453 |
| Practice Telephone | 4805282746 |
| Mailing Telephone | 4805282746 |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2020-01-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
Speech, Language and Hearing Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326419144 | Ebony Green | Counselor | 124 Durham Rd, Pollock, LA 71467 | 2015-10-20 |
| Street Address |
19670 E REINS RD |
| City | QUEEN CREEK |
| State | AZ |
| Zip Code | 85142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619386638 | Jessica Webb | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2014-08-04 |
| 1104450659 | Jetnor Sinani | Occupational Therapy Assistant | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2020-02-24 |
| 1164055943 | Gabriella Davidson | Occupational Therapy Assistant | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2020-02-19 |
| 1851924831 | Anna Louise Pasquinelli | Recreational Therapist Assistant | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2020-02-18 |
| 1609322916 | Jose Nunez | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2016-08-27 |
| 1114471513 | Cindi Aragon | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2016-08-15 |
| 1811348246 | Saundra Kennon | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2016-06-27 |
| 1164871042 | Ladan Samiei | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2016-06-10 |
| 1518316868 | Annette Vine | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2016-06-07 |
| 1801266036 | Angela Ainsworth | Speech-Language Pathologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2015-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093346033 | Arizona Dental Professionals, P.C. | Dentist | 20311 S Ellsworth Rd Ste 101, Queen Creek, AZ 85142 | 2020-01-29 |
| 1073158903 | Jonathan Corey Barber | Physical Therapy Assistant | 22424 South Ellsworth Loop Road, #464, Queen Creek, AZ 85142 | 2019-11-14 |
| 1689142333 | Erin Sohr | Occupational Therapy Assistant | 4594 W Federal Way, San Tan Valley, AZ 85142 | 2018-11-10 |
| 1083180723 | Katelyn Hannabach | Physician Assistant | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142 | 2018-10-20 |
| 1043701899 | Brittany Leigh Amor | Dentist | 18550 E Rittenhouse Rd Ste 103, Queen Creek, AZ 85142 | 2018-05-28 |
| 1861925604 | Shani Thompson | Student in an Organized Health Care Education/Training Program | 22437 S 209th Way, Queen Creek, AZ 85142 | 2017-04-08 |
| 1689115164 | 360 Physical Therapy LLC | Physical Therapist | 21576 S Ellsworth Loop Rd, 150, Queen Creek, AZ 85142 | 2017-03-16 |
| 1891233714 | Candee J. Eisenhart | Nurse Practitioner | 21321 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142 | 2017-02-11 |
| 1790231546 | Carrie Church | Nurse Practitioner | 20185 E Ocotillo Rd Ste 104, Queen Creek, AZ 85142 | 2016-08-31 |
| 1669836649 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 22713 S. Ellsworth Road, Building A, Queen Creek, AZ 85142 | 2016-04-06 |
| Find all providers in zip 85142 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508323510 | Shannon Alyse Nikula | Specialist/Technologist | 21168 E Tierra Grande Dr, Queen Creek, AZ 85142-6767 | 2019-02-26 |
| 1134632193 | Stacey Bonenberger | Specialist/Technologist | 22444 S 209th Way, Queen Creek, AZ 85142-4877 | 2017-11-13 |
| 1518401157 | Andrea Rowan | Specialist/Technologist | 20898 E Saddle Way, Queen Creek, AZ 85142-6552 | 2016-12-16 |
| 1124488960 | Aimee Bustos | Specialist/Technologist | 1302 W Plane Tree Ave, Queen Creek, AZ 85140-7679 | 2016-03-06 |
| 1154705150 | Amanda Stevens | Specialist/Technologist | 40300 N Simonton Blvd, Queen Creek, AZ 85140-3164 | 2015-07-20 |
| 1619386638 | Jessica Webb | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2014-08-04 |
| 1841613494 | Mary A Bak | Specialist/Technologist | 40388 N Parisi Pl, Queen Creek, AZ 85140-6826 | 2014-01-31 |
| 1003249533 | Michelle Marie Klym | Specialist/Technologist | 20061 E Rittenhouse Rd, Queen Creek, AZ 85142-9712 | 2013-08-20 |
| 1063792661 | Tracy B Wright | Specialist/Technologist | 21288 E Twin Acres Dr, Queen Creek, AZ 85142-6546 | 2011-08-26 |
| 1679852081 | Kylee Rai Nickerson | Specialist/Technologist | 21408 East Creosote Lane, Queen Creek, AZ 85142 | 2011-08-16 |
| Find all providers in QUEEN CREEK | ||||
| City | QUEEN CREEK |
| Zip Code | 85142 |
Please comment or provide details below to improve the information on EBONY GREEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.