Nathan Green O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5340358-9934 Issued in UT

Legal business name

NATHAN GREEN O.D., P.C.

Practice address

1818 S 300 W
Salt Lake City, UT 84115-1805

Phone

(801) 485-9757

Fax

(801) 485-8867

NPI assigned

Nov 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nathan Ray Green, OD

Title

President

Phone

(801) 485-9757

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1477735710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 S 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841151805",
            "telephone_number": "801-485-9757",
            "fax_number": "801-485-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 S 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841151805",
            "telephone_number": "801-485-9757",
            "fax_number": "801-485-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN GREEN O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-485-9757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5340358-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas George Nasser, MD
• Farshad Nassiri, MD, PHD
• Nate Ruden MD LLC
• Amelia Marie Nate, CSW
• Nathan G Momberger MD PC
• Nathan Jacquez CMHC
• David Jay Nathan, M.D.
• Carina Nation, ACMHC
• National Birth Centers, Inc.
• National Birth Centers, Inc.

• Optometrist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.