ST. PAUL CHILDREN'S MEDICAL CORPORATION (NPI# 1073842514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073842514 |
| Entity Type | Organization |
| Organization Name | ST. PAUL CHILDREN'S MEDICAL CORPORATION |
| Practice Address |
1358 E Richards St Tyler TX 75702-6153 |
| Mailing Address |
Po Box 1238 Tyler TX 75710-1238 |
| Practice Telephone | 9035319455 |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2009-12-11 |
| Authorized Official Name | SALEEN RHONDA HEARON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9035319455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
1358 E RICHARDS ST |
| City | TYLER |
| State | TX |
| Zip Code | 75702-6153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757077 | Dawn Marcelle Wilson | Social Worker | 1358 E Richards St, Tyler, TX 75702-6153 | 2020-10-15 |
| 1104232990 | Sara Hanson | Dietitian, Registered | 1358 E Richards St, Tyler, TX 75702-6153 | 2014-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770791717 | Genevieve J.t. Blackwelder | Pediatrics | 6526 Ashmore Ln, Tyler, TX 75703-5896 | 2007-05-21 |
| 1407940547 | Jerri Kathleen Moore | Pediatrics | 1306 Doctors Drive, Tyler, TX 75701 | 2006-10-03 |
| 1356445647 | William D Rishel | Pediatrics | 1130 Doctors Dr, Tyler, TX 75701-2123 | 2006-09-08 |
| 1730299306 | Tiffany Hill | Pediatrics | 1000 E 5th St Ste 100, Tyler, TX 75701-3307 | 2006-08-30 |
| 1649201484 | Rachel Jean Osina Nichols | Pediatrics | 1350 E Richards St, Tyler, TX 75702-6153 | 2006-07-06 |
| 1639107675 | Andrew E Hoover | Pediatrics | 1000 Fifth Street, Tyler, TX 75701 | 2006-06-29 |
| 1356316681 | Jennifer A Steeger | Pediatrics | 305 W Rusk St, Tyler, TX 75701-1514 | 2006-02-21 |
| 1841265477 | James Rick Rogers | Pediatrics | 706 Turtle Creek, Tyler, TX 75701 | 2006-02-17 |
| 1912971813 | Wendell A Jones | Pediatrics | 2990 N Broadway, Tyler, TX 75702 | 2006-02-15 |
| 1134199284 | Michael David Austin | Pediatrics | 1000 E 5th St, Tyler, TX 75701-3346 | 2006-01-23 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.