JONATHAN GREEN (NPI# 1548652332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548652332 |
| Entity Type | Individual |
| Full Name | JONATHAN GREEN |
| Practice Address |
710 Terry Ave Springdale AR 72764-6804 |
| Practice Telephone | 4792838509 |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2020-01-22 |
| NPI Deactivation Date | 01/06/2020 |
| NPI Reactivation Date | 2020-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720425390 | Jonathan Green | Surgery | 1200 Everett Dr Ste 2320, Oklahoma City, OK 73104-5047 | 2013-05-23 |
| 1225028210 | Jonathan Green | Physician Assistant | 10444 Sr 66 N, Newburgh, IN 47630-7954 | 2005-10-21 |
| 1760097679 | Jonathan Matthew Green | Pharmacist | 50 Irving St Nw, Washington, DC 20422-0001 | 2020-09-09 |
| 1235601055 | Jonathan Carson Green | Specialist/Technologist | 1000 E Main St, Danville, IN 46122-1948 | 2018-12-18 |
| 1952889347 | Jonathan Jorvell Green | Occupational Therapist | 3101 Ginger Dr, Tallahassee, FL 32308-4437 | 2018-07-30 |
| 1447754098 | Jonathan Green | Physical Therapist | 2620 Scripture St, Denton, TX 76201-4315 | 2018-03-20 |
| 1164930756 | Jonathan Green | Counselor | 5151 Adanson St, Orlando, FL 32804-1330 | 2018-01-17 |
| 1467829192 | Jonathan Michael Green | Specialist/Technologist, Other | 13 S Tejon St Fl 5, Colorado Springs, CO 80903-1513 | 2015-08-28 |
| 1144622382 | Jonathan Green | Registered Nurse | 257 Lafayette Ave, Suffern, NY 10901-4830 | 2014-09-18 |
| 1437568144 | Jonathan Green | Psychologist | 150 S Huntington Ave, 116b-4, Boston, MA 02130-4817 | 2014-08-06 |
| Street Address |
710 TERRY AVE |
| City | SPRINGDALE |
| State | AR |
| Zip Code | 72764-6804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1316592801 | Above and Beyond Pediatric Therapy, Inc | Speech-Language Pathologist | 2700 American St., Ste B, Springdale, AR 72764 | 2019-08-02 |
| 1053871061 | Specialized Hearing Instruments, Inc. | Audiologist-Hearing Aid Fitter | 958 S. West End St., Springdale, AR 72764 | 2019-03-25 |
| 1801385976 | Taylor Beauregard Kelamis | Nurse Practitioner | Mercy Clinic Family Medicine, 1110 W. Robinson Ave, Springdale, AR 72764 | 2018-05-04 |
| 1649726878 | Ember Estelle Lanuti Brown | Speech-Language Pathologist | 4209 Navajo Court, Springdale, AR 72764 | 2016-08-28 |
| 1568838241 | Elayna Wells | Speech-Language Pathologist | 900 S Powell Street, Springdale, AR 72764 | 2015-08-17 |
| 1184003261 | Okeyo Oghina | Nurse Practitioner | 609 West Maple Avenue, Northwest Health System, Springdale, AR 72764 | 2015-05-22 |
| 1235524869 | William M Rogers | Family Medicine | 513 N. Shiloh Street, Springdale, AR 72764 | 2015-03-31 |
| 1336498872 | Kelly Meeann Miller | Speech-Language Pathologist | 105 S Blair Street, Springdale, AR 72764 | 2012-08-30 |
| 1902183874 | Cristy Hoffman | Physical Therapy Assistant | 2837 American St Ste A, Springdale, AR 72764 | 2011-11-07 |
| Find all providers in zip 72764 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477190981 | Barry Gilliam | Peer Specialist | 220 Sycamore Ridge Dr, Springdale, PA 15144-1054 | 2019-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164032702 | Christopher Ray Rouse | Peer Specialist | 17235 Logan Cave Rd Lot 3, Siloam Springs, AR 72761-9223 | 2020-08-07 |
| 1538709290 | Kyle Ryan Keith | Peer Specialist | 25 Murphy Dr, Bella Vista, AR 72715-6913 | 2020-01-10 |
| 1588160634 | Terri Lashun Butler | Peer Specialist | 15 Azalea Loop, Conway, AR 72032-8522 | 2018-04-05 |
| 1750994257 | Laretta Machelle Solomon | Peer Specialist | 17235 Logan Cave Rd Lot 3, Siloam Springs, AR 72761-9223 | 2020-08-25 |
| 1053944504 | Lonnie Phillips | Peer Specialist | 1521 Merrill Dr, Little Rock, AR 72211-1821 | 2020-02-12 |
| 1679127450 | Donterries L Alexander | Peer Specialist | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2019-07-30 |
| 1437621018 | Gary Wade Carter | Peer Specialist | 615 W Grand Ave, Hot Springs, AR 71901-3927 | 2018-12-20 |
| 1588032684 | Michael William Jones | Peer Specialist | 1500 Dodson Ave, Fort Smith, AR 72901-5182 | 2015-09-04 |
| 1487993655 | Judy Weaver | Peer Specialist | 350 Salem Rd Ste 1, Conway, AR 72034 | 2013-02-08 |
| 1386898765 | Raymond Zachary Bates | Peer Specialist | 3111 S 70th St, Fort Smith, AR 72903-5017 | 2008-11-11 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGDALE |
| Zip Code | 72764 |
Please comment or provide details below to improve the information on JONATHAN 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.