MAKENZIE GREEN (NPI# 1174016976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174016976 |
| Entity Type | Individual |
| Full Name | MAKENZIE GREEN |
| Practice Address |
27 S Main Tooele UT 84074 |
| Mailing Address |
4460 S Highland Dr Salt Lake City UT 84124-3543 |
| Practice Telephone | 4355665927 |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427518125 | Makenzie Green | Behavior Technician | 625 Pennsylvania Ave, San Diego, CA 92103-4321 | 2019-03-20 |
| 1174047153 | Makenzie Elisabeth Green | Pharmacist | 111 4th Ave, Huntington, WV 25701-1219 | 2017-08-01 |
| Street Address |
27 S MAIN |
| 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 |
| 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 |
| 1760826184 | Headache Relief Specialists LLC | Chiropractor | 1244 No Main, Suite 100, Tooele, UT 84074 | 2013-04-29 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588144398 | Monique Mondragon | Case Manager/Care Coordinator | 684 Oquirrh Ave, Tooele, UT 84074-9235 | 2018-08-21 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1194339754 | Kylie Gardner | Case Manager/Care Coordinator | 754 N Main St, Tooele, UT 84074-1612 | 2020-09-01 |
| 1194290882 | Caralyn Dee Sly | Case Manager/Care Coordinator | 27 S Main St, Tooele, UT 84074-2158 | 2018-10-09 |
| 1396210084 | Shilo Miranda Mueller | Case Manager/Care Coordinator | 27 S Main St, Tooele, UT 84074-2158 | 2018-10-09 |
| 1144709775 | Paki Olive | Case Manager/Care Coordinator | 38 S Main St, Tooele, UT 84074-2132 | 2018-08-14 |
| 1619464831 | Jennifer Glick Swan | Case Manager/Care Coordinator | 100 S 1000 W, Tooele, UT 84074-4010 | 2018-04-13 |
| 1386147593 | Megan Perez | Case Manager/Care Coordinator | 100 S 1000 W, Tooele, UT 84074-4010 | 2018-03-14 |
| 1487938551 | Nicolle M Tennant-nicholas | Case Manager/Care Coordinator | 100 S 1000 W, Tooele, UT 84074-4010 | 2011-10-06 |
| 1952609646 | Samantha Marie Vincent | Case Manager/Care Coordinator | 100 S 1000 W, Tooele, UT 84074-4010 | 2011-03-04 |
| Find all providers in TOOELE | ||||
Please comment or provide details below to improve the information on MAKENZIE 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.