MR. CHARLES ITOE MISORI (NPI# 1629171293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629171293 |
| Entity Type | Individual |
| Full Name | MR. CHARLES ITOE MISORI |
| Credential | CRNP |
| Practice Address |
105 Teakwood Dr Sw Huntsville AL 35801-3454 |
| Mailing Address |
12201 Bluegrass Pkwy Louisville KY 40299-2361 |
| Practice Telephone | 2568815000 |
| Practice Fax Number | 2568818629 |
| Mailing Telephone | 5025687366 |
| Mailing Fax Number | 5025687114 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1094507 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
1094507 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
105 TEAKWOOD DR SW |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-3454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578980470 | Lp Huntsville, LLC | Skilled Nursing Facility | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2014-03-28 |
| 1255755039 | Whitesburg Gardens, LLC | Skilled Nursing Facility | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2014-02-13 |
| 1366885063 | Christa Deanette Brockway | Nurse Practitioner | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2013-04-11 |
| 1992089627 | Geetha Powers Jacob | Nurse Practitioner | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2011-09-29 |
| 1427205749 | Kelly Smith | Occupational Therapist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-08-19 |
| 1316103914 | Bonnie Eversole | Physical Therapist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-08-03 |
| 1144484304 | Shaunda Pachelle Payne | Occupational Therapist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-07-16 |
| 1952565129 | Courtney Lohse Iv | Speech-Language Pathologist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-07-16 |
| 1750545927 | Brenda Smith | Speech-Language Pathologist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-07-16 |
| 1548424724 | Elizabeth D Greer | Speech-Language Pathologist | 105 Teakwood Dr Sw, Huntsville, AL 35801-3454 | 2008-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356948368 | Starr Ellen Valerio | Nurse Practitioner | 115 Rachel Dr Nw, Huntsville, AL 35806 | 2020-10-02 |
| 1790135150 | Lilymit Moktan | Nurse Practitioner | 741 Plummer Rd, Huntsville, AL 35806-3815 | 2016-06-16 |
| 1639560964 | Alexander Eganhouse | Nurse Practitioner | 4700 Whitesburg Dr Sw Ste 200, Huntsville, AL 35802-1686 | 2015-02-09 |
| 1912268905 | Elsen Cheruto Dalizu | Nurse Practitioner | 209 Double Oak Dr Nw, Huntsville, AL 35806-1090 | 2012-06-06 |
| 1740549559 | Doris Elizabeth Clark | Nurse Practitioner | 813 Franklin Street, Huntsville, AL 35801-4311 | 2012-05-14 |
| 1316271430 | Cynthia H Whitten | Nurse Practitioner | 700 Airport Rd Sw Ste F, Huntsville, AL 35802-4360 | 2009-09-22 |
| 1306968565 | Mary Ann Mcdonald | Nurse Practitioner | 410 Sivley Rd Sw, Huntsville, AL 35810 | 2007-04-06 |
| 1114070786 | Mary Kate Bonilla | Nurse Practitioner | 400 Whitesport Dr Sw Suite 201, Huntsville, AL 35801-6429 | 2007-01-18 |
| 1265580021 | Tracey Tibbals Stansberry | Nurse Practitioner | 125 Litton's Covered Bridge Road, Huntsville, TN 37756-3809 | 2007-01-08 |
| 1821155813 | Amber Nolen Mcphail | Nurse Practitioner | 301 Sparkman Dr Nw, 127d Spragins Hall, Huntsville, AL 35805-1911 | 2007-01-02 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
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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.