MARK L DONOVAN (NPI# 1417952250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417952250 |
| Entity Type | Individual |
| Full Name | MARK L DONOVAN |
| Credential | M.D. |
| Practice Address |
301 Med Tech Pkwy Ste. 160 Johnson City TN 37604-2364 |
| Practice Telephone | 4237945560 |
| Practice Fax Number | 4237941801 |
| Mailing Telephone | 4237945560 |
| Mailing Fax Number | 4237941801 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2016-01-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 18834 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3042289 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568736775 | Mark Thomas Donovan | Technician/Technologist | 666 E Broadway, South Boston, MA 02127-1502 | 2012-03-06 |
| 1912909730 | Mark David Donovan | Counselor | 10630 Little Patuxent Pkwy, Suite 209, Columbia, MD 21044-3264 | 2005-08-11 |
| 1457695546 | Mark N Donovan | Surgery | 2801 Nw Mercy Dr Ste 330, Roseburg, OR 97471 | 2012-11-15 |
| 1629217633 | Mark James Donovan | Chiropractor | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2009-02-13 |
| 1922168814 | Mark T Donovan | Dentist | 150 N Pantano Rd, Suite 100, Tucson, AZ 85710 | 2006-12-11 |
| Street Address |
301 MED TECH PKWY STE. 160 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162748 | Alfonzo S Arze | Obstetrics & Gynecology | 301 Med Tech Pkwy, Suite 200, Johnson City, TN 37604 | 2005-05-23 |
| 1659933901 | Andrew A Kovacs | Nurse Practitioner | 301 Med Tech Pkwy, Johnson City, TN 37604-2630 | 2019-07-07 |
| 1114472883 | Tenessa A Tipton | Nurse Practitioner | 301 Med Tech Pkwy, Johnson City, TN 37604-2630 | 2016-08-23 |
| 1437604535 | Erika Masters | Registered Nurse | 301 Med Tech Pkwy, Suite 240, Johnson City, TN 37604-2364 | 2016-08-18 |
| 1013462407 | Ariel Denton | Nurse Practitioner | 301 Med Tech Pkwy, Suite 200, Johnson City, TN 37604-2364 | 2016-08-16 |
| 1023466786 | Tracy Romans | Registered Nurse | 301 Med Tech Pkwy, Suite 240, Johnson City, TN 37604-2364 | 2016-06-02 |
| 1073960381 | Erin Mcpherson | Registered Nurse | 301 Med Tech Pkwy, Suite 160, Johnson City, TN 37604-2364 | 2016-05-17 |
| 1265838650 | Vanessa L Ailey | Advanced Practice Midwife | 301 Med Tech Pkwy, Suite 200, Johnson City, TN 37604 | 2014-11-12 |
| 1336558626 | Angela D Deschner | Registered Nurse | 301 Med Tech Pkwy, Ste 240, Johnson City, TN 37604 | 2014-08-12 |
| 1770994972 | Sarah M Mcrae | Nurse Practitioner | 301 Med Tech Pkwy, Suite 240, Johnson City, TN 37604-2364 | 2014-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 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 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 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 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| 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 |
|---|---|---|---|---|
| 1922453190 | Rachel Michelle Lindsey | Pediatrics | 325 N State of Franklin Rd, Ground Floor, Etsu Physicians and Associates Pediatrics, Johnson City, TN 37604-6056 | 2016-04-25 |
| 1609261197 | Lauren Nichols Swift | Pediatrics | 325 N. State of Franklin Road, Ground Floor, Johnson City, TN 37604 | 2015-04-01 |
| 1437579760 | Daniel P Armentrout | Pediatrics | 301 Med Tech Pkwy Ste 160, Johnson City, TN 37604 | 2014-04-25 |
| 1225309891 | Medical Education Assistance Corporation | Pediatrics | 201 E Myrtle Ave, Johnson City, TN 37601 | 2012-01-13 |
| 1558673434 | Himabindu Kasivajjula | Pediatrics | 639 Main Street, Johnson City, NY 13790 | 2010-07-08 |
| 1558428037 | Beth W Hapke | Pediatrics | 512 Reynolds Rd, Apt K12, Johnson City, NY 13790-1366 | 2007-01-03 |
| 1750461265 | Shasta B Helsel | Pediatrics | 301 Med Tech Pkwy Ste 180, Johnson City, TN 37604 | 2006-10-17 |
| 1497738041 | Samuel Boi Addo | Pediatrics | 269 Riverside Dr, Johnson City, NY 13790-2726 | 2005-11-28 |
| 1831184266 | Otto H.p. Teixeira | Pediatrics | 325 N State of Franklin Rd., Ground Floor, Johnson City, TN 37604-6062 | 2005-09-12 |
| 1083619118 | Jodi B Gage | Pediatrics | 325 N. State of Franklin Road, Ground Floor, Johnson City, TN 37604 | 2005-06-16 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.