PATRICK GREEN MD PLLC (NPI# 1518256650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518256650 |
| Entity Type | Organization |
| Organization Name | PATRICK GREEN MD PLLC |
| Practice Address |
134 W 1180 N Suite # 5 Tooele UT 84074 |
| Practice Telephone | 4352480333 |
| Practice Fax Number | 4352480334 |
| Mailing Telephone | 4352480333 |
| Mailing Fax Number | 4352480334 |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-11-18 |
| Authorized Official Name | DR. PATRICK N GREEN (OWNER) |
| Authorized Official Telephone | 8018285857 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
134 W 1180 N SUITE # 5 |
| City | TOOELE |
| State | UT |
| Zip Code | 84074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548302268 | Advanced Practice Medical Clinic, LLC | Clinic/Center | 491 North Main Street, Tooele, UT 84074-0922 | 2007-02-12 |
| 1134390537 | Ram C Sharma, Md PC | Clinic/Center | 255 S 100 E, Tooele, UT 84074-2779 | 2008-03-13 |
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|---|---|---|---|---|
| 1700499183 | Grab Healthcare, LLC | Clinic/Center | 245 E 2150 N, Suite C, Layton, UT 84041 | 2020-08-26 |
| 1851917496 | Centre Health Group | Clinic/Center | 70 West Main, Suite B, American Fork, UT 84003 | 2020-06-19 |
| 1942821947 | First Choice Healthcare, LLC | Clinic/Center | 250 N American Way, Brigham City, UT 84302-2074 | 2020-04-30 |
| 1912526294 | Boyer Medical Solutions | Clinic/Center | 2322 N 2080 W, Lehi, UT 84043-4897 | 2020-04-16 |
| 1164066015 | Sterling Provider Group | Clinic/Center | 700 S Highway 91, Richmond, UT 84333-1209 | 2019-11-04 |
| 1760033443 | Careatc | Clinic/Center | 669 W 200 S, Salt Lake City, UT 84101-1014 | 2019-09-24 |
| 1174006605 | Bristol Palliative Care Services, L.L.C. | Clinic/Center | 3216 S Highland Dr Ste 100, Salt Lake City, UT 84106-4196 | 2018-09-11 |
| 1649790080 | Jupiter Medical II LLC | Clinic/Center | 7724 S 5600 W Ste 102, West Jordan, UT 84081-5415 | 2017-06-27 |
| 1932640752 | Indiemed LLC | Clinic/Center | 25 N 2000 W Ste 3, Hurricane, UT 84737-4115 | 2017-03-13 |
| 1649719063 | Sara Arrington, A.p.r.n., P.l.l.c | Clinic/Center | 3110 W 300 N Ste A, West Point, UT 84015-7481 | 2017-02-17 |
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| 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.