Active NPI
Jenett Green, PTA
- Physical Therapy Assistant
- Murray, UT
National Provider Identifier
1073819868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 106283-8019
- Practice address
- 5121 Cottonwood St
Box 577000
Murray, UT 84107-5701 - Phone
- (801) 507-7000
- NPI assigned
- Jan 27, 2011
- Last updated
- Jan 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 106283-8019 | UT | Primary |
Addresses
Primary practice location
5121 Cottonwood St
Box 577000
Murray, UT 84107-5701
Mailing address
238 E 900 N
Nephi, UT 84648-1029
Phone (435) 623-0604
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106283-8019 | UT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296086400000",
"number": "1073819868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 E 900 N",
"city": "NEPHI",
"state": "UT",
"postal_code": "846481029",
"telephone_number": "435-623-0604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5121 COTTONWOOD ST",
"address_2": "BOX 577000",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075701",
"telephone_number": "801-507-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JENETT",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-27",
"last_updated": "2011-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "UT",
"license": "106283-8019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.