DR. MICHAEL RICHARD GREEN (NPI# 1356384226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356384226 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL RICHARD GREEN |
| Credential | M.D. |
| Practice Address |
1490 E Foremaster Dr # 260 St George UT 84790-4488 |
| Mailing Address |
1490 E Foremaster Dr Suite 260 St George UT 84790-4488 |
| Practice Telephone | 4356880156 |
| Practice Fax Number | 4356880330 |
| Mailing Telephone | 4356880156 |
| Mailing Fax Number | 4356880330 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-06-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
95-875021205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636186 | Michael James Green | Specialist/Technologist | 632 Noble Ct, Grand Junction, CO 81504-6987 | 2019-02-20 |
| 1063903995 | Michael Jamiel Green | Non-emergency Medical Transport (VAN) | 3816 Schooner Trl, Chesapeake, VA 23321-3215 | 2018-05-26 |
| 1144735051 | Michael Scott Green | Emergency Medical Technician, Paramedic | 315 Heathrow Dr, Hiram, GA 30141-2341 | 2017-12-14 |
| 1861934176 | Michael Green | Student in an Organized Health Care Education/Training Program | 9 Q St Ne, Washington, DC 20002-2105 | 2016-11-17 |
| 1245789528 | Michael Monroe Green | Counselor | 1048 Jackson Ave, Sharon Hill, PA 19079-1608 | 2016-09-27 |
| 1225429251 | Michael Thomas Green | Specialist/Technologist | 1651 51st St, Sacramento, CA 95819-4503 | 2015-02-12 |
| 1003119611 | Michael T Green | Dentist | 1900 N. Roselle Rd, #401, Schaumburg, IL 60195 | 2010-12-21 |
| 1760794515 | Michael Green | Chiropractor | 5101 Bel Air St, Boise, ID 83705-2774 | 2010-07-09 |
| 1316175292 | Michael Green | Emergency Medicine | Naval Hospital Camp Pendleton 200 Mercy Circle, Oceanside, CA 92055 | 2009-06-30 |
| 1548469562 | Michael S Green | Dentist | 2244 Green Hedges Way, Ste #102, Wesley Chapel, FL 33544-8189 | 2007-07-11 |
| Street Address |
1490 E FOREMASTER DR # 260 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-4488 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184623092 | Jeffrey Lee Stewart | Podiatrist | 1490 E Foremaster Dr, Suite 250, St George, UT 84790-4488 | 2005-07-21 |
| 1396256293 | Craniom | Specialist/Technologist, Other | 1490 E Foremaster Dr, St George, UT 84790-4488 | 2017-10-18 |
| 1790221687 | Wendy Utley | Nurse Practitioner | 1490 E Foremaster Dr, Suite 350, St George, UT 84790-4488 | 2017-01-16 |
| 1033662705 | Brittany Garcia | Audiologist | 1490 E Foremaster Dr, Suite 360, St George, UT 84790-4488 | 2016-07-29 |
| 1609252691 | Coral Desert Foot & Ankle PC | Durable Medical Equipment & Medical Supplies | 1490 E Foremaster Dr, Suite 250, St George, UT 84790-4488 | 2015-08-03 |
| 1629480769 | Jacob Burrows | Audiologist | 1490 E Foremaster Dr, Suite 360, St George, UT 84790-4488 | 2014-05-23 |
| 1740605963 | Ivo Kekoa Hanza | Nurse Practitioner | 1490 E Foremaster Dr, St George, UT 84790-4488 | 2014-02-25 |
| 1578985438 | Emere Utah LLC | Orthopaedic Surgery | 1490 E Foremaster Dr, Suite 260, St George, UT 84790-4488 | 2014-01-13 |
| 1760752943 | Central Utah Clinic, P.C. | Orthopaedic Surgery | 1490 E Foremaster Dr, Suite 150, St George, UT 84790-4488 | 2012-01-05 |
| 1568754364 | Nathan W Aston | Physician Assistant | 1490 E Foremaster Dr, #150, St George, UT 84790-4488 | 2011-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427456797 | Intermountain Healthcare | Orthopaedic Surgery | 652 S Medical Center Dr, Suite 120, St George, UT 84790-7049 | 2014-12-18 |
| 1578985438 | Emere Utah LLC | Orthopaedic Surgery | 1490 E Foremaster Dr, Suite 260, St George, UT 84790-4488 | 2014-01-13 |
| 1649426800 | Ihc Health Services Inc | Orthopaedic Surgery | 652 S Medical Center Dr, #ll20, St George, UT 84790-0000 | 2008-08-07 |
| 1104953652 | Ihc Health Services Inc | Orthopaedic Surgery | 652 S Medical Center Dr, Suite 400, St George, UT 84790-7017 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811265044 | Lonnie Paulos Md PC | Orthopaedic Surgery | 324 East 10th Avenue, Ste 172, Salt Lake City, UT 84103-3184 | 2011-12-02 |
| 1477865491 | Ihc Health Services Inc | Orthopaedic Surgery | 1159 E 200 N Ste 100, American Fork, UT 84003-2053 | 2010-07-07 |
| 1558546739 | Mark A.rosen Md, LLC | Orthopaedic Surgery | 5911 Fashion Blvd., Suite 100, Murray, UT 84107 | 2008-01-07 |
| 1255422192 | Bruce E Thomas | Orthopaedic Surgery | 5957 Fashion Point Dr, Suite 101, Ogden, UT 84403-5180 | 2006-09-27 |
| 1922098334 | Eric A Heiden | Orthopaedic Surgery | 2200 Park Ave Bldg D, Park City, UT 84060-7246 | 2005-10-26 |
| 1487646998 | Robert B Bourne | Orthopaedic Surgery | 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124-1275 | 2005-08-19 |
| 1992700330 | Leon E Paulos | Orthopaedic Surgery | 324 10th Ave, Suite 175, Salt Lake City, UT 84103-2853 | 2005-06-14 |
| 1366917577 | Kevin Dale Newbold | Orthopaedic Surgery | 3895 Harrison Blvd, Ogden, UT 84403-2312 | 2018-10-04 |
| 1588162283 | Alpine Management and Consulting | Orthopaedic Surgery | 2310 N 400 E Ste A, Logan, UT 84341-1796 | 2018-01-28 |
| 1083128730 | Kia Wilson | Orthopaedic Surgery | 375 S Chipeta Way, Salt Lake City, UT 84108-1260 | 2017-11-16 |
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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.