DR. PERIKA SHAUGN DEROCHE (NPI# 1093001422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093001422 |
| Entity Type | Individual |
| Full Name | DR. PERIKA SHAUGN DEROCHE |
| Credential | MD |
| Practice Address |
40 Arch St Johnson City NY 13790-2102 |
| Practice Telephone | 6077636075 |
| Practice Fax Number | 6077635234 |
| Mailing Telephone | 6077636075 |
| Mailing Fax Number | 6077635234 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
40 ARCH ST |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578568150 | Lorne R Campbell Sr. | Family Medicine | 40 Arch St, Johnson City, NY 13790-2102 | 2005-06-20 |
| 1124405600 | Lauren Zagieboylo | Student in an Organized Health Care Education/Training Program | 40 Arch St, Johnson City, NY 13790-2102 | 2015-05-04 |
| 1699194159 | Aditya Mehta | Family Medicine | 40 Arch St, Johnson City, NY 13790-2102 | 2014-04-14 |
| 1649699117 | Shownak Shreyarthi | Family Medicine | 40 Arch St, Johnson City, NY 13790-2102 | 2014-04-14 |
| 1295154730 | Mckirven Ceus | Family Medicine | 40 Arch St, Johnson City, NY 13790-2102 | 2014-04-14 |
| 1972920981 | Judith Lathrop Samsel | Registered Nurse | 40 Arch St, Johnson City, NY 13790-2102 | 2014-03-27 |
| 1043633878 | Julie Douglass | Dietitian, Registered | 40 Arch St, Johnson City, NY 13790-2102 | 2014-01-30 |
| 1619303104 | Jon-erik Wagner | Student in an Organized Health Care Education/Training Program | 40 Arch St, Johnson City, NY 13790-2102 | 2013-09-17 |
| 1821433095 | Saqib Iqbal | Student in an Organized Health Care Education/Training Program | 40 Arch St, Johnson City, NY 13790-2102 | 2013-05-01 |
| 1194085803 | Tyson Don Brierley | Family Medicine | 40 Arch St, Johnson City, NY 13790-2102 | 2012-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585668 | Mohammad Darweesh | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd # 439-7280, Johnson City, TN 37604-6056 | 2020-07-16 |
| 1407484157 | Kayla Page | Student in an Organized Health Care Education/Training Program | 23 Riale Ave, Johnson City, NY 13790-2707 | 2020-03-30 |
| 1932736030 | Trishna Sharma | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive Mountain Home, Johnson City, TN 37684 | 2020-03-26 |
| 1962063743 | Pooja Kumar | Student in an Organized Health Care Education/Training Program | 400 N St Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-24 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1396309324 | Praveen Shilpa Fernandopulle | Student in an Organized Health Care Education/Training Program | 1276 Gilbreath Dr # 70300, Johnson City, TN 37614-6503 | 2019-04-25 |
| 1609439686 | Alok Kumar Sinha | Student in an Organized Health Care Education/Training Program | Va Bldg 1, Johnson City, TN 37614-6503 | 2019-04-16 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1689171951 | Matthew David Carpenter | Student in an Organized Health Care Education/Training Program | Va Bldg 1, Dogwood Avenue, Johnson City, TN 37614-0622 | 2018-04-12 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
Please comment or provide details below to improve the information on DR. PERIKA SHAUGN DEROCHE.
| 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.