NOLAN IVIE (NPI# 1174143390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174143390 |
| Entity Type | Individual |
| Full Name | NOLAN IVIE |
| Credential | MBA IONM |
| Practice Address |
111 Boland St Ste 211 Ft Worth TX 76107-1265 |
| Practice Telephone | 8175298488 |
| Practice Fax Number | 9033286568 |
| Mailing Telephone | 8175298488 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
111 BOLAND ST STE 211 |
| City | FT WORTH |
| State | TX |
| Zip Code | 76107-1265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396133328 | Synapses Iom LLC | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2014-12-29 |
| 1972104826 | Jacob Dickson | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-11-06 |
| 1902405657 | Spine Pain Nm LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-10-23 |
| 1063010916 | Andre Ribeiro | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-10-13 |
| 1114524915 | Yvette Ibarra | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-10-05 |
| 1265048458 | Rousseau Iom LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-09-22 |
| 1306450051 | Mnk Healthcare Monitoring LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-09-01 |
| 1427673334 | Saspine Consulting LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-06-16 |
| 1003438524 | Candance Pitts | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-05-07 |
| 1285256701 | Nts Neuromonitring LLC | Electrodiagnostic Medicine | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-05-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104826 | Jacob Dickson | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-11-06 |
| 1063010916 | Andre Ribeiro | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-10-13 |
| 1114524915 | Yvette Ibarra | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-10-05 |
| 1003438524 | Candance Pitts | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-05-07 |
| 1295357713 | Cory Rahmings | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-05-07 |
| 1063033256 | Afia Davis | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-04-29 |
| 1154941961 | Robin Schutt | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-04-22 |
| 1689293078 | Dona Cortes | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-04-15 |
| 1164056883 | Rudolph Seide | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-03-03 |
| 1215577341 | Jamie Jacksooo | Specialist/Technologist, Other | 111 Boland St Ste 211, Ft Worth, TX 76107-1265 | 2020-01-07 |
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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.