BRADY GREEN (NPI# 1720526445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720526445 |
| Entity Type | Individual |
| Full Name | BRADY GREEN |
| Practice Address |
1720 N Westgate Dr Boise ID 83704-7164 |
| Practice Telephone | 2083340800 |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | ID | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417243742 | Brady Korry Green | Pharmacist | 1135 W Riverdale Rd, Riverdale, UT 84405-3722 | 2011-06-24 |
| Street Address |
1720 N WESTGATE DR |
| City | BOISE |
| State | ID |
| Zip Code | 83704-7164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245561505 | Jaime Rochelle Marshall | Community Health Worker | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2010-01-26 |
| 1568026698 | Sarah Rosenbloom | Social Worker | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2019-04-24 |
| 1093297228 | Eric John Leitzinger II | Student in an Organized Health Care Education/Training Program | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-09-04 |
| 1275015703 | Cade Kirkhart | Counselor | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-08-31 |
| 1124508619 | Amy Palmer | Developmental Therapist | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-08-15 |
| 1427543958 | Monisha Oconnor | Counselor | 1720 N Westgate Dr, Boise, ID 83704 | 2018-06-27 |
| 1154830081 | Tyler Quinn Kerns | Student in an Organized Health Care Education/Training Program | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2017-09-22 |
| 1033635990 | Jessica Anderson | Registered Nurse | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2017-08-22 |
| 1043742943 | Melissa Ann Howard | Social Worker | 1720 N Westgate Dr, Suite A1, Boise, ID 83704-7164 | 2017-03-30 |
| 1265973788 | John Griffin | Registered Nurse | 1720 N Westgate Dr, Suire A-1, Boise, ID 83704-7164 | 2017-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733694 | Susan L Boone | Student in an Organized Health Care Education/Training Program | 8506 W Donnybrook Dr, Boise, ID 83709-0606 | 2020-09-02 |
| 1730715855 | Madison Hiatt | Student in an Organized Health Care Education/Training Program | 1209 W Targee St, Boise, ID 83706-4565 | 2020-03-20 |
| 1053946202 | Kaitlyn Casper | Student in an Organized Health Care Education/Training Program | 267 W Arrowrock Ln, Boise, ID 83706-4802 | 2020-03-09 |
| 1952955825 | Lani Jo Hernandez | Student in an Organized Health Care Education/Training Program | 6200 N River Pointe Dr Apt B203, Boise, ID 83714-1848 | 2019-07-30 |
| 1033679865 | Bryce Ellis Turnbull | Student in an Organized Health Care Education/Training Program | 1128 S Garden Pl, Boise, ID 83705-5845 | 2019-03-20 |
| 1306331186 | Alexander Combs | Student in an Organized Health Care Education/Training Program | 5526 N Rothmans Ave, Boise, ID 83713-0950 | 2018-06-25 |
| 1528552031 | Matthew James Wolter | Student in an Organized Health Care Education/Training Program | 3145 S Falling Brook Ln, Boise, ID 83706-5205 | 2018-06-18 |
| 1376037218 | Avery Garner | Student in an Organized Health Care Education/Training Program | 12371 W Goldenrod Ave, Boise, ID 83713-0001 | 2018-06-14 |
| 1760914345 | Hugo Cesar Araujo Lino | Student in an Organized Health Care Education/Training Program | 869 E Holly St, Boise, ID 83712-7840 | 2017-04-01 |
| 1740711019 | Ryan James Blaser | Student in an Organized Health Care Education/Training Program | 912 W Hays St Apt 4, Boise, ID 83702-5461 | 2017-03-27 |
| Find all providers in BOISE | ||||
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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.