Active NPI
Tarnell Joseph Green
- Behavior Technician
- Pueblo, CO
National Provider Identifier
1427704451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 205517
- Practice address
- 401 Broadway Ave
Pueblo, CO 81004-2127 - Phone
- (719) 387-7775
- NPI assigned
- Feb 28, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 205517 | CO | Primary |
Addresses
Primary practice location
401 Broadway Ave
Pueblo, CO 81004-2127
Mailing address
44 Montebello Rd Apt 306C
Pueblo, CO 81001-1347
Phone (409) 791-6442
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 |
|---|---|---|---|
| 205517 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646006400000",
"number": "1427704451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 MONTEBELLO RD APT 306C",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011347",
"telephone_number": "409-791-6442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BROADWAY AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810042127",
"telephone_number": "719-387-7775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TARNELL",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-28",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "205517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.