DUSTIN WATTENBERGER (NPI# 1003231432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003231432 |
| Entity Type | Individual |
| Full Name | DUSTIN WATTENBERGER |
| Practice Address |
1100 Richmond Rd Irvine KY 40336-7231 |
| Mailing Address |
Po Box 636493 Cincinnati OH 45263-6493 |
| Practice Telephone | 6067237706 |
| Practice Fax Number | 6067269410 |
| Mailing Telephone | 5139815130 |
| Mailing Fax Number | 5139815015 |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2015-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3008537 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100291580 | 05 |
| Street Address |
1100 RICHMOND RD |
| City | IRVINE |
| State | KY |
| Zip Code | 40336-7231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205807849 | Pamela Jones | Nurse Practitioner | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2006-01-31 |
| 1669952644 | Bobbie Jean Allen | Registered Nurse | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2018-08-18 |
| 1316387079 | Tamera Shea Spangler | Family Medicine | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2013-06-26 |
| 1689814675 | Tonya Justice | Family Medicine | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2009-03-03 |
| 1114075835 | Mary Jane Doyle | Nurse Practitioner | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2007-01-08 |
| 1811071475 | Katisha Ednacot | Physician Assistant | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2006-10-24 |
| 1417061995 | Billie Jean Kelley | Nurse Practitioner | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2006-08-19 |
| 1912968603 | Maher Kassis | Internal Medicine | 1100 Richmond Rd, Irvine, KY 40336-7231 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949848 | Belinda Sue Gadd | Technician | 988 Reges Rd., Irvine, KY 40336 | 2020-07-20 |
| 1790076156 | Jan Andrea Brandenburg | Pharmacist | 110 Richmond Road, Irvine, KY 40336 | 2011-04-20 |
| 1427283647 | Health Help Incorporated | Clinic/Center | 30 Stacy Lane Road, Irvine, KY 40336 | 2009-05-18 |
| 1003037375 | Bluegrass Cardiology Psc | Internal Medicine | 60 Mercy Court, Irvine, KY 40336 | 2007-05-02 |
| 1770705873 | Herbert W Long | Clinic/Center | 417 River Drive, Irvine, KY 40336 | 2007-05-02 |
| 1255478053 | Lisa M Ford | Dentist | 161 Richmond Rd, Irvine, KY 40336 | 2007-01-31 |
| 1750468047 | Jason W Gay | Dentist | 10 River Drive, Irvine, KY 40336 | 2006-11-01 |
| 1184718702 | Lawrence Edward Griesinger IIi | Psychologist | 100 Tyler Lane, Irvine, KY 40336 | 2006-10-03 |
| 1407235666 | Emergency Medicine Physicians of Estill County,pllc | Physician Assistant | 60 Mercy Ct, Irvine, KY 40336 | 2015-05-21 |
| 1013198753 | Kristy Lee Bledsoe | Dietitian, Registered | 365 River Drive, Irvine, KY 40336-0115 | 2007-11-23 |
| Find all providers in zip 40336 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447866132 | Lisa Yoensil Yoon Park | Nurse Practitioner | 9204 Esperanza, Irvine, CA 92618-1749 | 2020-09-18 |
| 1922613702 | Jennifer Elbel Hill | Nurse Practitioner | 16100 Sand Canyon Ave Ste 130, Irvine, CA 92618-3722 | 2020-09-09 |
| 1649898743 | Aimee Johanna Rodriguez | Nurse Practitioner | 3237 Grand Canal, Irvine, CA 92620-1707 | 2020-07-06 |
| 1407318314 | Marlon Herrera Carpio | Nurse Practitioner | 17 Pacific Crst, Irvine, CA 92602-2408 | 2019-04-01 |
| 1316404007 | Annie Tak | Nurse Practitioner | 2 Hughes Ste 150, Irvine, CA 92618-2036 | 2019-02-28 |
| 1164998886 | Ashkan Bastani | Nurse Practitioner | 9 Mecklenberg, Irvine, CA 92620-2727 | 2018-10-19 |
| 1174001507 | Melanie Bernus Tallakson | Nurse Practitioner | 1100 Gottschalk Medical Plaza, Irvine, CA 92697 | 2018-07-28 |
| 1003322306 | Katherine Lin Matsumoto | Nurse Practitioner | 250 E Yale Loop Ste 204, Irvine, CA 92604-4697 | 2017-12-21 |
| 1518481431 | Nueva Parazo Singian | Nurse Practitioner | 7725 Gateway Unit 1239, Irvine, CA 92618-1573 | 2017-08-02 |
| 1861920191 | Sindu Shelly | Nurse Practitioner | 23 Poppy, Irvine, CA 92618-6922 | 2017-05-31 |
| Find all providers in IRVINE | ||||
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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.