MARK WATHEN (NPI# 1104925536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104925536 |
Entity Type | Individual |
Full Name | MARK WATHEN |
Credential | MD |
Practice Address |
228 W 4th St Suite 200 Cookeville TN 38501-2488 |
Practice Telephone | 9313720405 |
Practice Fax Number | 9313720463 |
Mailing Telephone | 9313720405 |
Mailing Fax Number | 9313720463 |
Enumeration Date | 2006-09-22 |
Last Update Date | 2019-03-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | 23921 | TN | Allopathic & Osteopathic Physicians |
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
23921 | TN | Allopathic & Osteopathic Physicians |
Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
23921 | TN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TN | 1509597 | 05 | |
TN | BCBS | 4288686 | 01 |
Street Address |
228 W 4TH ST SUITE 200 |
City | COOKEVILLE |
State | TN |
Zip Code | 38501-2488 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982605382 | Jennifer L Mabry | Registered Nurse | 228 W 4th St, Ste 200, Cookeville, TN 38501-2488 | 2005-08-09 |
1679904494 | Karli Qualls | Physician Assistant | 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 | 2013-12-04 |
1043652738 | Angeli B Swallows | Nurse Practitioner | 228 W 4th St, Suite 301, Cookeville, TN 38501-2488 | 2013-07-23 |
1841497203 | Brian R Dulin | Internal Medicine | 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 | 2007-06-29 |
1083743413 | Brian Keith Dockery | Internal Medicine | 228 W 4th St, Suite 200, Cookeville, TN 38501-2488 | 2007-03-02 |
1588733877 | Tennessee Heart Pllc | Specialist | 228 W 4th St, Suite 200, Cookeville, TN 38501-2489 | 2006-11-08 |
1265480867 | Steven Bickel | Physician Assistant | 228 W 4th St, Suite 301, Cookeville, TN 38501-2488 | 2006-05-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811596711 | Results-ast Jv, LLC | Physical Therapist | 627 James Campbell Blvd, South, Suite B, Columbia, TN 38501 | 2020-10-21 |
1376167080 | Melinda Jane Jetter | Registered Nurse | 320 North Willow Avenue, Cookeville, TN 38501 | 2020-05-29 |
1366950875 | Tara Beth Smith | Occupational Therapist | 315 N Washington Ave Ste 240, Cookeville, TN 38501 | 2018-01-18 |
1669990339 | Tonya Rachelle Perry | Counselor | 13 South Jefferson Ave, Cookeville, TN 38501 | 2017-09-01 |
1659896207 | Dustin Chase Rich | Physical Therapist | 105 S. Willow Ave, #100, Cookeville, TN 38501 | 2017-08-04 |
1487009668 | Holly Young | Physical Therapist | 315 North Washungton Ave., Suite 240, Cookeville, TN 38501 | 2016-04-26 |
1194190306 | Johnna Sprague | Nurse Practitioner | 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 | 2015-12-14 |
1881099885 | Carlos Alberto Podesta | Internal Medicine | 238 W 4th St Ste 200, Cookeville, TN 38501 | 2014-11-03 |
1124445002 | Shashank Sarvepalli | Internal Medicine | 1 Medical Center Blvd Ste D, Cookeville, TN 38501 | 2014-03-27 |
1689095762 | Kendra Hicks | Licensed Practical Nurse | 701 County Services Drive, Cookeville, TN 38501 | 2013-12-17 |
Find all providers in zip 38501 |
Taxonomy Code | 207RC0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Clinical Cardiac Electrophysiology |
A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861015935 | Basu Ray Cardiology Associates PC | Internal Medicine | 1755 Groveway Dr, Germantown, TN 38139-5554 | 2020-05-25 |
1538391446 | Indranill Basu Ray | Internal Medicine | 6005 Park Ave Ste 500b, Memphis, TN 38119 | 2009-08-12 |
1548266786 | Tibor Sandor Szabo | Internal Medicine | 7460 Wolf River Blvd, Germantown, TN 38138-1760 | 2005-06-22 |
1275811713 | Knoxville Hma Cardiology Ppm, LLC | Internal Medicine | 1225 E Weisgarber Rd, Knoxville, TN 37909-2604 | 2011-08-02 |
1518279686 | Chattanooga Hamilton County Hospital Authority | Internal Medicine | 979 E 3rd St, Suite C-520, Chattanooga, TN 37403-2136 | 2010-07-06 |
1174842181 | Specialty Physician Group LLC | Internal Medicine | 7460 Wolf River Blvd, Germantown, TN 38138-1760 | 2010-06-01 |
1831332626 | Karine Guerrier | Internal Medicine | 848 Adams Ave, Ste. L400, Memphis, TN 38103 | 2009-04-09 |
1518122613 | Martin Antonio Espinosa | Internal Medicine | 222 22nd Ave N, Suite 400, Nashville, TN 37203-1852 | 2008-07-28 |
1093978751 | Rashmi Ujaneppa Hottigoudar | Internal Medicine | 7557b Dannaher Dr Ste 225, Powell, TN 37849-3568 | 2008-07-02 |
1265606255 | Przemyslaw Peter Borek | Internal Medicine | 2400 Patterson St Ste 502, Nashville, TN 37203-6511 | 2008-04-22 |
Find all providers with the same taxonomy |
City | COOKEVILLE |
Zip Code | 38501 |
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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.