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

241 W 2100 S
South Salt Lake, UT 84115-1830

Phone

(801) 401-1068

NPI assigned

Dec 30, 2015

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) 401-1068

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1952766362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 W 2100 S",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841151830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W 2100 S",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841151830",
            "telephone_number": "801-401-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN GREEN O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "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": "801-401-1068",
        "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": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.