ROATHIPOUN PO (NPI# 1407460074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407460074 |
| Entity Type | Individual |
| Full Name | ROATHIPOUN PO |
| Credential | AGACNP-BC |
| Practice Address |
5428 Hickory Woods Dr Antioch TN 37013-5678 |
| Practice Telephone | 6155549272 |
| Mailing Telephone | 6155549272 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0200X |
Registered Nurse Specialization: Critical Care Medicine |
188273 | TN | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
28231 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5428 HICKORY WOODS DR |
| City | ANTIOCH |
| State | TN |
| Zip Code | 37013-5678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538706155 | Aisha Lbhalla | In Home Supportive Care | 324 Schoolhouse Ct, Antioch, TN 37013 | 2019-12-02 |
| 1023516580 | Aida Attia Faltas | Pharmacist | 608 Copper Rideg Trail, Antioch, TN 37013 | 2018-01-30 |
| 1700304839 | Good Shepherd Pharmacy LLC | Pharmacy | 2717 B Murfreesboro Pike, Antioch, TN 37013 | 2017-09-08 |
| 1053836593 | Inspired By Love Home Care, Inc. | In Home Supportive Care | 257 Maxwell Pl, Antioch, TN 37013 | 2017-08-05 |
| 1003354614 | Bridgestone Pharmacy LLC | Pharmacy | 825 Hamilton Crossings, Antioch, TN 37013 | 2017-02-02 |
| 1215388947 | Stattee Medical Transpoprtation Inc | Non-emergency Medical Transport (VAN) | 340 Schoolhouse Ct, Antioch, TN 37013 | 2016-06-23 |
| 1518313055 | Alisha Lampley | Counselor | 804 Thomas Bay Court, Antioch, TN 37013 | 2016-05-13 |
| 1467821835 | Clifton Mcdaniel | Respiratory Therapist, Certified | 3165 Skinner Dr, Antioch, TN 37013 | 2015-09-16 |
| 1497149884 | Frank Hamilton Anderson Iv | Family Medicine | 2572 Treetop Dr, Antioch, TN 37013 | 2015-03-24 |
| 1013356757 | Kevin Eugene Groh | Physician Assistant | 5380 Hickory Hollow Pkwy Ste 201, Antioch, TN 37013 | 2013-06-16 |
| Find all providers in zip 37013 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548191 | Anne Nicole Koethe | Nurse Practitioner | Saint Thomas Medical Group, 4230 Harding Pike #503, Nashville, TN 37205 | 2020-11-06 |
| 1063034429 | Jared Garrison | Nurse Practitioner | 700 Harbor Edge Dr Apt 102, Memphis, TN 38103-5840 | 2020-05-08 |
| 1548893472 | Caroline Kelly Pigford | Nurse Practitioner | 5737 Sarah Dr, Ooltewah, TN 37363-6465 | 2020-02-19 |
| 1447883343 | Jennifer Leigh Slater | Nurse Practitioner | 109 Williamsburg Blvd, Tullahoma, TN 37388-5412 | 2020-02-19 |
| 1811529118 | Michelle Filomena Grise | Nurse Practitioner | 1466 Tiny Town Rd, Clarksville, TN 37042-8291 | 2020-02-05 |
| 1902445935 | Brad Harrell, Dnp LLC | Nurse Practitioner | 233 Lackey Ln, Ripley, TN 38063-1619 | 2019-12-20 |
| 1861039612 | Teresa Hea Brown | Nurse Practitioner | 180 Melodie Cir, Henderson, TN 38340-3628 | 2019-11-27 |
| 1962044883 | Seph Kestner | Nurse Practitioner | 1215 21st Ave S Fl Mce5, Nashville, TN 37232-0014 | 2019-10-11 |
| 1003457409 | Leven Ward | Nurse Practitioner | 250 Hartfield Dr, Medina, TN 38355-8941 | 2019-10-07 |
| 1619527124 | Amelia Hoyt Laws | Nurse Practitioner | Vanderbilt University Medical Center 1211, Nashville, TN 37232-0001 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
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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.