DR. JOHN M. ROACH (NPI# 1164425831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164425831 |
| Entity Type | Individual |
| Full Name | DR. JOHN M. ROACH |
| Credential | M.D |
| Practice Address |
242 Berger Rd Paducah KY 42003-4522 |
| Mailing Address |
4645 Village Square Dr Suite C Paducah KY 42001-7448 |
| Practice Telephone | 2703660960 |
| Practice Fax Number | 2715541108 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2019-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39216 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | NPI GROUP | 1427478700 | 01 |
| KY | KY STATE LICENSE | 39216 | 01 |
| KY | 64095565 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4645 Village Square Dr, Suite C, Paducah, KY 420017448 | 2709999999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477867588 | John J Roach | Surgery | 2616 24th Ave E, Seattle, WA 98112-2002 | 2010-07-30 |
| 1881640639 | John B Roach Jr. | Specialist | 17723 Hunting Bow Cir, Suite 101, Lutz, FL 33558-5371 | 2006-05-25 |
| 1417930421 | John Michael Roach | Internal Medicine | 811 S Auburn, Kennewick, WA 99336 | 2005-11-23 |
| 1750929840 | John Tiption Roach IIi | Nurse Anesthetist, Certified Registered | 701 Princeton Ave Sw, Birmingham, AL 35211-1303 | 2019-12-19 |
| 1962863811 | John David Roach Jr. | Counselor | 2814 S Us Highway 1 Ste D4, Fort Pierce, FL 34982-8110 | 2016-03-18 |
| 1518921766 | John M Roach | Ophthalmology | 3225 Cumberland Blvd Se Ste 800, Atlanta, GA 30339-5970 | 2006-04-14 |
| 1376503474 | John G Roach IIi | Family Medicine | 105 Vest Mill Cir, Winston-salem, NC 27103-2943 | 2006-03-24 |
| Street Address |
242 BERGER RD |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003-4522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427478700 | Bluegrass Pediatrics, LLC | Nurse Practitioner | 242 Berger Rd, Paducah, KY 42003 | 2014-04-24 |
| 1912270125 | Kathy L Olson | Nurse Practitioner | 242 Berger Rd, Paducah, KY 42003-4522 | 2012-02-17 |
| 1043372279 | Lifeworks Aesthetic Center, Psc | Specialist | 242 Berger Rd, Paducah, KY 42003-4522 | 2006-12-14 |
| 1851329122 | Peter Allan Ward | Plastic Surgery | 242 Berger Rd, Paducah, KY 42003-4522 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902105224 | Personal Medicine of Kentucky Pllc | Pediatrics | 2320 Broadway St Ste 110, Paducah, KY 42001-7146 | 2011-03-25 |
| 1174841357 | Rachel Lowdenback | Pediatrics | 548 Lone Oak Road, Paducah, KY 42003-4538 | 2010-05-12 |
| 1821168154 | John T. Cecil Jr. | Pediatrics | 2670 New Holt Rd Ste C, Paducah, KY 42001-7506 | 2006-11-08 |
| 1922001601 | James Shumaker | Pediatrics | 1532 Lone Oak Rd, Ste 345, Paducah, KY 42003-7942 | 2005-05-24 |
| 1598138984 | Sheridan Children's Healthcare Services of Kentucky, Inc. | Pediatrics | 1530 Lone Oak Rd, Paducah, KY 42003-7901 | 2015-11-06 |
| 1225471782 | Caitlyn Cecil | Pediatrics | 2670 New Holt Rd Ste C, Paducah, KY 42001-7506 | 2013-04-15 |
| 1225399322 | Holly Denise Payne | Pediatrics | 548 Lone Oak Rd, Paducah, KY 42003-4538 | 2012-06-05 |
| 1154584605 | Elizabeth Claire Mcgregor | Pediatrics | 2605 Kentucky Ave, Doctor's Building #3, Paducah, KY 42003-3800 | 2008-07-04 |
| 1194711721 | Glen Chaney | Pediatrics | 2605 Kentucky Ave, Paducah, KY 42003-3800 | 2005-09-20 |
| 1649266271 | David Schell | Pediatrics | 2605 Kentucky Ave, Drs Bldg 3 Suite 501, Paducah, KY 42003-3800 | 2005-09-20 |
| Find all providers in PADUCAH | ||||
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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.