BOONPHIPHOP BOONPHENG (NPI# 1659723104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659723104 |
| Entity Type | Individual |
| Full Name | BOONPHIPHOP BOONPHENG |
| Credential | M.D. |
| Practice Address |
1 Dogwood Avenue Carl A. Jones Hall, Va Building Mountain Home Johnson City TN 37684 |
| Practice Telephone | 4234396283 |
| Mailing Telephone | 4234396283 |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2016-07-08 |
| 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 | Student, Health Care |
| Street Address |
1 DOGWOOD AVENUE CARL A. JONES HALL, VA BUILDING MOUNTAIN HOME |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730524 | Kendra Lee Thorne | Psychologist | Corner of Lamont St and Veterans Way, Building 160, Mountain Home, TN 37684 | 2020-11-04 |
| 1255930160 | Maximillian Scott Crockett | Optometrist | James. H Quillen Vamc, Eye Clinic 112e, Mountain Home, TN 37684 | 2020-10-21 |
| 1699393256 | Joshua Thomas Spencer | Pharmacist | Veterans Way and Lamont St, Mountain Home, TN 37684 | 2020-07-10 |
| 1073140265 | James Hankil Kim | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive, Mountain Home, TN 37684 | 2020-03-26 |
| 1932736030 | Trishna Sharma | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive Mountain Home, Johnson City, TN 37684 | 2020-03-26 |
| 1508421884 | Sarvatit Patel | Student in an Organized Health Care Education/Training Program | 52 Lake Dr, Mountain Home, TN 37684 | 2019-05-02 |
| 1902366024 | Katelyn Cserjes | Student in an Organized Health Care Education/Training Program | Building 52 Lake Drive Va Medical Center, Mountain Home, TN 37684 | 2019-03-24 |
| 1114404282 | Anesa Ellen Hughes | Pharmacist | Veterans Way and Lamont St Mountain Home, Mountain Home, TN 37684 | 2018-07-23 |
| 1508352287 | Leon Nguyen | Optometrist | James H. Quillen Vamc - Lamont St & Veterans Way, Eye Clinic 112e, Mountain Home, TN 37684 | 2018-07-06 |
| 1649761750 | Bahaaeldin Ibrahim Mahmoud Youssef | Student in an Organized Health Care Education/Training Program | Va Building 1 Carl A Jones Hall, Dogwood Avenue, Mountain Home, TN 37684 | 2018-05-24 |
| Find all providers in zip 37684 | ||||
| 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 |
|---|---|---|---|---|
| 1619585668 | Mohammad Darweesh | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd # 439-7280, Johnson City, TN 37604-6056 | 2020-07-16 |
| 1407484157 | Kayla Page | Student in an Organized Health Care Education/Training Program | 23 Riale Ave, Johnson City, NY 13790-2707 | 2020-03-30 |
| 1932736030 | Trishna Sharma | Student in an Organized Health Care Education/Training Program | Building 52/lake Drive Mountain Home, Johnson City, TN 37684 | 2020-03-26 |
| 1962063743 | Pooja Kumar | Student in an Organized Health Care Education/Training Program | 400 N St Franklin Rd, Johnson City, TN 37604-6035 | 2019-06-24 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1396309324 | Praveen Shilpa Fernandopulle | Student in an Organized Health Care Education/Training Program | 1276 Gilbreath Dr # 70300, Johnson City, TN 37614-6503 | 2019-04-25 |
| 1609439686 | Alok Kumar Sinha | Student in an Organized Health Care Education/Training Program | Va Bldg 1, Johnson City, TN 37614-6503 | 2019-04-16 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1689171951 | Matthew David Carpenter | Student in an Organized Health Care Education/Training Program | Va Bldg 1, Dogwood Avenue, Johnson City, TN 37614-0622 | 2018-04-12 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37684 |
Please comment or provide details below to improve the information on BOONPHIPHOP BOONPHENG.
| 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.