DR. SHANE PATRICK ROCHE (NPI# 1649724782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649724782 |
| Entity Type | Individual |
| Full Name | DR. SHANE PATRICK ROCHE |
| Credential | D.M.D. |
| Practice Address |
1001 Covington St Youngstown OH 44510-1617 |
| Mailing Address |
1250 Signature Dr Youngstown OH 44515-3867 |
| Practice Telephone | 3304801366 |
| Practice Fax Number | 3304801366 |
| Mailing Telephone | 3308816197 |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | OH | Student, Health Care |
| Street Address |
1001 COVINGTON ST |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44510-1617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115900 | Heath A Dorion | Surgery | 1001 Covington St, Youngstown, OH 44510-1617 | 2005-09-27 |
| 1093362543 | Chitsimran Mann | Internal Medicine | 1001 Covington St, Youngstown, OH 44510-1617 | 2019-08-20 |
| 1649836024 | Amanda Ellis | Dentist | 1001 Covington St, Youngstown, OH 44510-1617 | 2019-05-12 |
| 1770045643 | Ahmad Mourra | Internal Medicine | 1001 Covington St, Youngstown, OH 44510-1617 | 2019-04-01 |
| 1700360740 | Abubaker Salih | Student in an Organized Health Care Education/Training Program | 1001 Covington St, Youngstown, OH 44510-1617 | 2018-09-15 |
| 1104318468 | Charles A Page | Student in an Organized Health Care Education/Training Program | 1001 Covington St, Youngstown, OH 44510-1617 | 2018-06-03 |
| 1114419454 | Kevin Johnson | Dentist | 1001 Covington St, Youngstown, OH 44510-1617 | 2018-06-02 |
| 1477044352 | Jeana Mcevey | Dentist | 1001 Covington St, Youngstown, OH 44510-1617 | 2018-05-25 |
| 1104341510 | Erika Marie Mikula | Nurse Practitioner | 1001 Covington St, Youngstown, OH 44510-1617 | 2017-08-07 |
| 1427579325 | Nene Azubuike | Internal Medicine | 1001 Covington St, Youngstown, OH 44510-1617 | 2017-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750889457 | Abolfazl Sodagar | Internal Medicine | 1001 Covington Street, Youngstown, OH 44510 | 2018-01-28 |
| 1285298422 | Kabir Kunwar | Internal Medicine | 1001 Covington Ave, Youngstown, OH 44510 | 2019-04-23 |
| 1861978603 | Fatemeh Dehghan Manshadi | Counselor | 611 Belmont Avenue, Youngstown, OH 44510 | 2018-07-16 |
| 1356361075 | Fred R Pruitt | Internal Medicine | 550 Parmalee Ave, Suite 310, Youngstown, OH 44510 | 2006-07-19 |
| 1912900341 | Scientific Medical Imaging, Inc. | Specialist | 540 Parmalee Ave, Suite 100, Youngstown, OH 44510 | 2005-05-31 |
| 1972128130 | Destiny Frost | Home Health Aide | 2749 Hammaker St, Youngstown, OH 44510-1037 | 2020-06-13 |
| 1225638547 | Sharell Shanta Williams | Nurse's Aide | 1102 Norwood Ave, Youngstown, OH 44510-1104 | 2020-10-27 |
| 1396965695 | Anthony Guy Gambone | Dentist | 813 Catalina Ave, Youngstown, OH 44510-1206 | 2007-04-27 |
| 1578548830 | Brian P Brocker | Neurological Surgery | 1616 Covington St, Youngstown, OH 44510-1244 | 2005-12-09 |
| 1134316664 | Brian P. Brocker M.d., Inc | Specialist | 1616 Covington St, Youngstown, OH 44510-1244 | 2007-09-28 |
| Find all providers in zip 44510 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346879137 | Firdous Inderyas | Student in an Organized Health Care Education/Training Program | 924 Pearson Cir Unit 3, Youngstown, OH 44512-5738 | 2020-04-03 |
| 1104473941 | Maegan Briant | Student in an Organized Health Care Education/Training Program | 4689 Woodhurst Dr Apt 3, Youngstown, OH 44515-3741 | 2019-08-26 |
| 1245897289 | Amrita K Dhanoa | Student in an Organized Health Care Education/Training Program | St. Elizabeth Youngstown Hospital., 1053 Belmont Avenue, Youngstown, OH 44501 | 2019-05-24 |
| 1497312573 | Parth Shah | Student in an Organized Health Care Education/Training Program | Western Reserve Health Education, 500 Gypsy Lane, Medical Office Building A, Youngstown, OH 44504 | 2019-05-23 |
| 1104318617 | Siddharth Paresh Mehta | Student in an Organized Health Care Education/Training Program | 500 Gypsy Lane. Western Reserve Health Education, Inc., Youngstown, OH 45501 | 2018-05-31 |
| 1104314889 | Anique Mustafa | Student in an Organized Health Care Education/Training Program | 500 Gypsy Lane., Western Reserve Education, Inc., Youngstown, OH 44501 | 2018-04-27 |
| 1588161814 | Stephen Lentz Derryberry Jr. | Student in an Organized Health Care Education/Training Program | 1044 Belmont Ave Dept Of, Youngstown, OH 44504-1006 | 2018-04-12 |
| 1760910509 | Ryan Gallagher | Student in an Organized Health Care Education/Training Program | 1001 Covington Ave, Youngstown, OH 44504 | 2017-05-24 |
| 1164046793 | Bree Hunter | Student in an Organized Health Care Education/Training Program | 100 Broadway Ave, Youngstown, OH 44505-2789 | 2020-05-29 |
| 1023630936 | Dana Schwartz | Student in an Organized Health Care Education/Training Program | 1044 Belmont Ave, Youngstown, OH 44504-1006 | 2020-05-13 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44510 |
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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.