DR. ANDRE FALLOT (NPI# 1730158213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730158213 |
| Entity Type | Individual |
| Full Name | DR. ANDRE FALLOT |
| Credential | MD |
| Practice Address |
Jackson Ave Bldg 9040 Madigan Army Medical Center Dept of Pediatrics Tacoma WA 98431-0001 |
| Mailing Address |
1767 Jensen Ave Dupont WA 98327-8707 |
| Practice Telephone | 2539681874 |
| Mailing Telephone | 2535074190 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2012-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
60051227 | WA | Allopathic & Osteopathic Physicians |
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
60051227 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
JACKSON AVE BLDG 9040 MADIGAN ARMY MEDICAL CENTER DEPT OF PEDIATRICS |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891767273 | Stephanie Ann Meyer | Dietitian, Registered | Jackson Ave Bldg 9040, Tacoma, WA 98431-0001 | 2006-02-01 |
| 1184082091 | Benjamin David Finch Jr. | Family Medicine | Jackson Ave Bldg 9040, Tacoma, WA 98431-0001 | 2016-02-05 |
| 1265727218 | Jaime Shaffer | Physician Assistant | Jackson Ave Bldg 9040, Tacoma, WA 98431-0001 | 2011-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, 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. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689637563 | Martha Alice Mccravey | Pediatrics | 314 Martin Way, Tacoma, WA 98405-4269 | 2006-04-10 |
| 1255652731 | Ashley T Jones | Pediatrics | 317 Martin Luther King Jr Way, Mary Bridge Children's Hospital, Tacoma, WA 98405 | 2010-06-18 |
| 1326059056 | Iain R Asplin | Pediatrics | 314 Martin Luther King Jr Way, Suite 9, Tacoma, WA 98405-4250 | 2006-08-10 |
| 1831140029 | Liliana Angelica Lupu | Pediatrics | 314 Martin Luther King Jr Way, Suite 9, Tacoma, WA 98405-4250 | 2006-05-13 |
| 1811951015 | Eric Harry | Pediatrics | 9040 Jackson Ave, Tacoma, WA 98431-4234 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306378278 | Pliceliany Perez | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2017-03-30 |
| 1184057267 | Ashley Deline Calahan | Pediatrics | 1344 Wintergreen Ln Ne, Bainbridge Island, WA 98110 | 2013-08-13 |
| 1972846079 | Whitney Elizabeth Kopp | Pediatrics | 101 W 8th Ave, Spokane, WA 99204-2307 | 2013-03-27 |
| 1710276761 | Emily Berkman | Pediatrics | 4800 Sand Point Way Ne, A-5950, Seattle, WA 98105 | 2011-03-30 |
| 1003077025 | Leslie Ann Dervan | Pediatrics | 4800 Sand Point Way Ne, Mb.10.620, Seattle, WA 98105-3901 | 2008-06-23 |
| 1861651929 | Silvia Hartmann | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2008-06-04 |
| 1538338975 | Amelie Olga-marie Von Saint Andre - Von Arnim | Pediatrics | 4800 Sand Point Way Ne, M/s W-8866, Seattle, WA 98105-3901 | 2008-02-28 |
| 1992907208 | Derk August Mueller | Pediatrics | 101 W 8th Ave, Spokane, WA 99204-2307 | 2007-05-31 |
| 1508921024 | Ofer Yanay | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-12-26 |
| 1275607913 | Thomas V. Brogan | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2006-11-17 |
| 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.