IAN MALL (NPI# 1144689456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144689456 |
| Entity Type | Individual |
| Full Name | IAN MALL |
| Other Name | IAN MALL |
| Practice Address |
9981 Forrest Dr Ooltewah TN 37363-8300 |
| Practice Telephone | 4233628192 |
| Mailing Telephone | 4233628192 |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SH0200X |
Clinical Nurse Specialist Specialization: Home Health |
20836 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9981 FORREST DR |
| City | OOLTEWAH |
| State | TN |
| Zip Code | 37363-8300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203196 | University Health Center | Clinic/Center | 4687 University Drive, Ooltewah, TN 37363 | 2019-09-05 |
| 1508426560 | Alexandra Scott | Dentist | 8985 Old Lee Hwy, Suite 103, Ooltewah, TN 37363 | 2019-06-20 |
| 1093286304 | Wright Pediatric Dentistry | Dentist | 8202 Apison Pike, Ooltewah, TN 37363 | 2018-12-13 |
| 1770052888 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 6085 Arbury Way, Ooltewah, TN 37363 | 2018-11-19 |
| 1679055008 | Rebecca Brown | Nurse Practitioner | 9801 Robinson Farm Rd, Ooltewah, TN 37363 | 2018-09-01 |
| 1750877833 | Amanda Kirkpatrick | Dietitian, Registered | 6103 Hunter Crest Drive, Ooltewah, TN 37363 | 2018-07-02 |
| 1447759493 | Abigale Daniels | Specialist/Technologist | 6154 Wardwell Drive, Ooltewah, TN 37363 | 2018-02-06 |
| 1538671748 | Ryan Volking | Physician Assistant | 7564 Passport Dr, Ooltewah, TN 37363 | 2017-10-27 |
| 1255882270 | Stella Tsui | Physical Therapy Assistant | 3818 Chanterwood Trl, Ooltewah, TN 37363 | 2016-10-14 |
| 1013392299 | Rhonda Wilson | Counselor | 5516 Barons Point, Ooltewah, TN 37363 | 2015-07-29 |
| Find all providers in zip 37363 | ||||
| Taxonomy Code | 364SH0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Home Health |
| Definition to come... |
Please comment or provide details below to improve the information on IAN MALL.
| 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.