MARY COLLEEN COSTELLO (NPI# 1306138672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306138672 |
| Entity Type | Individual |
| Full Name | MARY COLLEEN COSTELLO |
| Credential | MD |
| Practice Address |
2018 W Clinch Ave Knoxville TN 37916-2301 |
| Mailing Address |
Po Box 634706 Cincinnati OH 45263-4706 |
| Practice Telephone | 8655418000 |
| Practice Fax Number | 8659857077 |
| Mailing Telephone | 8652923000 |
| Mailing Fax Number | 8652923015 |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2017-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD47246 | TN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD47246 | TN | Allopathic & Osteopathic Physicians |
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
MD47246 | TN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770891657 | Mary Kelley Costello | Registered Nurse | 4084 W 56th St, Cleveland, OH 44144-1842 | 2010-09-14 |
| 1497922157 | Mary Elizabeth Costello | Nurse Practitioner | 400 South Orange Avenue, Seton Hall University Health Services, South Orange, NJ 07079-2697 | 2008-05-13 |
| 1639372204 | Mary Joanne Costello | Social Worker | 5317 N Clark St Fl 2, Chicago, IL 60640 | 2007-06-08 |
| 1568605673 | Mary Angela Costello | Social Worker | 16200 19 Mile Rd, Clinton Township, MI 48038-1103 | 2009-04-20 |
| 1548426414 | Mary A Costello | Nurse Practitioner | 3311 Riverbend Dr, Springfield, OR 97477-8800 | 2008-07-31 |
| 1447371489 | Mary Martha Costello | Social Worker | 22 Linwood Ave, B, Bel Air, MD 21014-3951 | 2007-04-03 |
| 1841215399 | Mary K Costello | Pediatrics | 1 Perkins Sq, Akron, OH 44308-1063 | 2006-07-13 |
| Street Address |
2018 W CLINCH AVE |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37916-2301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285633925 | Aleshia Lynn-ann Lunsford | Emergency Medicine | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2005-07-15 |
| 1649783705 | Jordan Brush Taylor | Registered Nurse | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2017-11-13 |
| 1124562152 | Catherine Ann Van Ostrand | Registered Nurse | 2018 W Clinch Ave, Scripps Network Tower, 2nd Floor, Knoxville, TN 37916 | 2016-12-09 |
| 1841733888 | Sara Pritschet | Dietitian, Registered | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2016-11-23 |
| 1912310707 | Kristen Jackson Slusher | Dietitian, Registered | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2014-06-09 |
| 1295163525 | Grace Macmorran | Physician Assistant | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2013-10-23 |
| 1134560642 | Amy Love Long | Physician Assistant | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2013-07-12 |
| 1033475694 | East Tennessee Children's Hospital Ass'n. | Specialist | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2012-04-09 |
| 1578843595 | Elizabeth Kyle Cook | Registered Nurse | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2011-08-22 |
| 1184903312 | Joshua David Ogle | Pharmacist | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2011-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151322 | Chelsea Raye Tanner | Registered Nurse | American Anesthesiology of Tennessee, 501 20th Street, Suite 606, Knoxville, TN 37916 | 2020-10-13 |
| 1003473372 | Mary Katrina Quist Rouse | Nurse Practitioner | 2100 Clinch Ave Ste 330, Knoxville, TN 37916 | 2019-05-22 |
| 1457881724 | Leslie Lynette Taylor | Physical Medicine & Rehabilitation | 2120 Highland Avenue, Knoxville, TN 37916 | 2017-06-19 |
| 1235547423 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 2429 University Commons Way, Knoxville, TN 37916 | 2014-07-31 |
| 1801182340 | Jessica Lee Sheah | Psychiatry & Neurology | 2100 W Clinch Avenue, Suite 210, Knoxville, TN 37916 | 2011-06-23 |
| 1326203548 | Bradley Jason Davis | Internal Medicine | 1819 Clinch Ave Ste 114, Knoxville, TN 37916 | 2008-07-28 |
| 1003012782 | East Tennessee Children's Hospital Association, Inc | Clinic/Center | 2100 West Clinch Avenue, Suite 510, Knoxville, TN 37916 | 2007-06-21 |
| 1922203108 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 611 22nd Street, Knoxville, TN 37916 | 2007-06-18 |
| 1699825984 | Orthodontic Design By Michael Sawaf | Dentist | 2220 White Ave, Knoxville, TN 37916 | 2007-01-11 |
| 1427115096 | Deborah Lynne Maples | Physical Therapy Assistant | Nhc Ft Sanders 2120 Highland Ave, Knoxville, TN 37916 | 2007-01-03 |
| Find all providers in zip 37916 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144764937 | Anytime Pediatrics | Pediatrics | 2517 Wrights Ferry Rd, Knoxville, TN 37919-9141 | 2016-12-13 |
| 1538252705 | East Tennessee Children's Hospital | Pediatrics | 2018 Clinch Avenue, Knoxville, TN 37916 | 2006-10-02 |
| 1023112414 | Pediatric Analgesia & Sedation Specialists | Pediatrics | 2018 Clinch Avenue, Knoxville, TN 37916-2228 | 2006-09-07 |
| 1487680211 | J. Michael Connors | Pediatrics | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225328354 | Nicholas Edward Jones | Pediatrics | 2200 Childrens Way Ste 1025, Nashville, TN 37232 | 2011-04-11 |
| 1275777526 | Haley Marie Polhill | Pediatrics | 2200 Patterson St, Nashville, TN 37203 | 2009-04-29 |
| 1174770895 | Meena Narasimhan | Pediatrics | 8010 Stage Hills Blvd, Bartlett, TN 38133-4032 | 2008-08-25 |
| 1508991852 | Joseph Arnold Weinberg | Pediatrics | 1842 Elmhurst Dr, Germantown, TN 38138-2771 | 2007-02-23 |
| 1275522534 | Barbara J Solomon | Pediatrics | 2200 Childrens Way, Suite 1014, Nashville, TN 37232-9001 | 2005-10-19 |
| 1770580011 | Daniel Joseph Duvall | Pediatrics | 801 Pine St, 6-c, Chattanooga, TN 37402-2520 | 2005-07-01 |
| 1447806880 | Megan Colleen Mccollum | Pediatrics | 2200 Childrens Way, Nashville, TN 37232-0005 | 2019-08-12 |
| 1528420361 | James Ashton Fisher | Pediatrics | 848 Adams Ave, Memphis, TN 38103-2816 | 2016-03-22 |
| 1366732422 | Emily Fain | Pediatrics | 3601 The Vanderbilt Clinic, Nashville, TN 37232-3026 | 2011-04-11 |
| 1669761789 | Caroline Sarah Watnick | Pediatrics | 2200 Children's Way, Monroe Carell Jr. Children's Hospital At Vanderbilt, Nashville, TN 37232 | 2011-03-29 |
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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.