DR. BETHANY GREEN (NPI# 1518512086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518512086 |
| Entity Type | Individual |
| Full Name | DR. BETHANY GREEN |
| Credential | DNP, MSN-ED., FNP-C |
| Practice Address |
10920 S River Front Pkwy South Jordan UT 84095-3538 |
| Mailing Address |
178 W Short Tailed Saratoga Springs UT 84045-6462 |
| Practice Telephone | 8018781095 |
| Mailing Telephone | 8018548763 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9099972-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104363126 | Bethany Theresa Green | Massage Therapist | 1002 Nw 23rd Ave, Gainesville, FL 32609-5403 | 2017-01-28 |
| 1396196648 | Bethany Weston Green | Nurse Practitioner | 150 E 42nd St, New York, NY 10017-5612 | 2016-06-28 |
| 1770945586 | Bethany Green | Nurse Practitioner | 3443 Dickerson Pike, Ste. 680, Nashville, TN 37207 | 2016-03-22 |
| 1770975260 | Bethany Green | Social Worker | 5103 W Pierson Rd, Suite 3, Flint, MI 48504-1395 | 2015-02-20 |
| Street Address |
10920 S RIVER FRONT PKWY |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306886924 | Daniel Eugene Long | Dentist | 10920 S River Front Pkwy, Roseman University College of Dental Medicine, South Jordan, UT 84095-3538 | 2006-06-08 |
| 1114544269 | Ahmad Majed Al Ashi | Student in an Organized Health Care Education/Training Program | 10920 S River Front Pkwy, South Jordan, UT 84095-3538 | 2020-07-05 |
| 1104484377 | Vijay Kale | Pharmacist | 10920 S River Front Pkwy, South Jordan, UT 84095-3538 | 2019-06-03 |
| 1285193581 | Andrea Josephine Chaveleh | Student in an Organized Health Care Education/Training Program | 10920 S River Front Pkwy, South Jordan, UT 84095-3538 | 2019-03-16 |
| 1578689055 | Sharon Angelici | Dentist | 10920 S River Front Pkwy, #557, South Jordan, UT 84095-3538 | 2007-03-22 |
| 1679505010 | Katherine P Thom | Pharmacist | 10920 S River Front Pkwy, South Jordan, UT 84095-3538 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617404 | Michaelle Lei Spears | Nurse Practitioner | 922 W Baxter Dr, South Jordan, UT 84095-8613 | 2020-10-18 |
| 1518585025 | Courtney Marie Gormus | Nurse Practitioner | 4616 W Pale Moon Ln, South Jordan, UT 84009-5036 | 2020-07-10 |
| 1841812260 | Teresa Diane Goodner | Nurse Practitioner | 10217 S Walnut Canyon Ln, South Jordan, UT 84009-7141 | 2020-05-07 |
| 1326692476 | Megan Jane Christensen | Nurse Practitioner | 10848 S Fern Ridge Dr, South Jordan, UT 84009-7764 | 2019-07-26 |
| 1700348497 | Julian Leonie Bassaragh | Nurse Practitioner | 9624 S Royalty Ln, South Jordan, UT 84095-3449 | 2019-04-02 |
| 1316426059 | Tawni Marie Aleman | Nurse Practitioner | 11732 S Tallac Dr, South Jordan, UT 84095-1215 | 2018-08-13 |
| 1508383175 | Cynthia Ann Whiting | Nurse Practitioner | 10433 S Redwood Rd Ste B, South Jordan, UT 84095-8502 | 2017-08-24 |
| 1437670114 | Andrea Jackson | Nurse Practitioner | 406 W S Jordan Pkwy, South Jordan, UT 84095-3965 | 2017-07-03 |
| 1124548789 | Tamara Lynn Broadhead | Nurse Practitioner | 10294 S Royal Vista Cv, South Jordan, UT 84095-3045 | 2017-06-26 |
| 1437574373 | Lee Hamilton | Nurse Practitioner | 9728 S 1650 W, South Jordan, UT 84095-9347 | 2014-03-01 |
| Find all providers in SOUTH JORDAN | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
Please comment or provide details below to improve the information on DR. BETHANY 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.