RACHAEL SUZANNE MIR (NPI# 1073750337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073750337 |
| Entity Type | Individual |
| Full Name | RACHAEL SUZANNE MIR |
| Practice Address |
650 Joel Dr Fort Campbell KY 42223-5318 |
| Practice Telephone | 2707988400 |
| Mailing Telephone | 2707988400 |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
66786 | TN | Ambulatory Health Care Facilities |
| Street Address |
650 JOEL DR |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601803 | Carol Lynn Pasewark | Counselor | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2005-07-07 |
| 1568063519 | Jeremy Schadewald | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-05 |
| 1578164760 | Brandi Mangan | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-04 |
| 1912506692 | Rose Dunn | Optometrist | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-10-22 |
| 1659989440 | Patrick Ogden | Student in an Organized Health Care Education/Training Program | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-17 |
| 1487262408 | John William Zamora | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1295343218 | Joshua Ryan Agard | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1902424435 | Shaina Escribano-miranda | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-10 |
| 1326665514 | Cristal Lagail Trotter | Nurse Anesthetist, Certified Registered | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-03 |
| 1689209728 | William James Bradshaw | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386883718 | Angel Blair | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-02-09 |
| 1982842084 | Willie Williams Jr. | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-27 |
| 1528205747 | Jodi A Rodriguez | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-09 |
| 1730326968 | Annette C Wade | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-09 |
| 1922245141 | Nancy Renee Smith | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-09 |
| 1912144122 | Alma Bruce | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-09 |
| 1962649236 | Ernesto Cruz | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-08 |
| 1174760490 | Candy Lynn Freeman | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-08 |
| 1750528022 | Ruth F Wells | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-08 |
| 1700022126 | Shannon Walker | Clinic/Center | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2009-01-07 |
| Find all providers in FORT CAMPBELL | ||||
| City | FORT CAMPBELL |
| Zip Code | 42223 |
Please comment or provide details below to improve the information on RACHAEL SUZANNE MIR.
| 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.