Kirby Arnesto Green, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

014738 Issued in LA

Practice address

2290 South 1300 East
Medical Marts
Salt Lake City, UT 84106-2831

Phone

(801) 474-0800

Fax

(810) 467-1126

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Marts LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
  • NPI 1053322834
  NPD (past)
• Van Meter MD & Associates

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1275638272
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1619909744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 S 1300 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062831",
            "telephone_number": "801-474-0800",
            "fax_number": "801-467-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 SOUTH 1300 EAST",
            "address_2": "MEDICAL MARTS",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062831",
            "telephone_number": "801-474-0800",
            "fax_number": "810-467-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KIRBY",
        "middle_name": "ARNESTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "014738",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "6053966-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200785958001",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194841",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Marie Green, RPH
• Imani Green
• Jacob Alton Green
• Jeffrey Green, MD
• Jessica Green
• Kristen Hillary Green, O.D.
• Kylee Mae Green
• Michael Matthew Green, D.O.
• Nathan Ray Green, O.D.
• Rachal Green

• Emergency Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.