WATAUGA LAKE FAMILY MEDICINE PC (NPI# 1457548406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457548406 |
| Entity Type | Organization |
| Organization Name | WATAUGA LAKE FAMILY MEDICINE PC |
| Practice Address |
140 Mcqueen St. Butler TN 37640 |
| Mailing Address |
138 N Fork New River Rd Lansing NC 28643-9130 |
| Practice Telephone | 4237680195 |
| Mailing Telephone | 3369822158 |
| Mailing Fax Number | 3369823373 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | MS. AMY R. MILLER (BUSINESS MANAGER) |
| Authorized Official Telephone | 3369822158 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD0000041068 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
140 MCQUEEN ST. |
| City | BUTLER |
| State | TN |
| Zip Code | 37640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699217406 | Angela Wolfenberger | Dietitian, Registered | 984 Piercetown Rd, Butler, TN 37640-5010 | 2016-11-10 |
| 1922469717 | Patricia Scott | Counselor | 114 Piercetown Rd, Suite 105, Butler, TN 37640-8068 | 2016-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891392817 | Mason Coffman | Chiropractor | 101 N Lyon St, Butler, MO 64730-2131 | 2020-10-02 |
| 1730794645 | Alfa Development Inc. | Assisted Living Facility | 97 Bartholdi Ave, Butler, NJ 07405-1426 | 2020-09-09 |
| 1518570373 | Kendra Marie Mariacher | Physician Assistant | 102 Technology Dr Ste 230-240, Butler, PA 16001-1784 | 2020-08-31 |
| 1336752484 | Trent Sebastian Vandevort | Specialist/Technologist | 239 La Ray Dr, Butler, PA 16001-1425 | 2020-08-28 |
| 1811500119 | Jessica Bair | Counselor | 120 Campus Ln, Butler, PA 16001-2662 | 2020-08-26 |
| 1679185839 | Pathways Human Services of Pennsylvania, LLC | Community/Behavioral Health | 200 Renaissance Dr Ste 401, Butler, PA 16001-7612 | 2020-08-19 |
| 1295347888 | Freemans Early Intervention Services | Community/Behavioral Health | 13 Peach St, Butler, GA 31006 | 2020-08-17 |
| 1518575299 | Ieisha Alzanam | Behavior Technician | 106 Plantation Dr, Butler, GA 31006-5503 | 2020-07-17 |
| 1245855261 | Healthcare Connections Community Health Services, LLC | Clinic/Center | 212 Woodley Ave, Butler, AL 36904-2738 | 2020-06-15 |
| 1346861036 | Seth Kunkle | Massage Therapist | 120 Hollywood Dr Ste 202, Butler, PA 16001-7604 | 2020-05-04 |
| Find all providers in BUTLER | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609163674 | Biju Raju | Family Medicine | 1395 State Rt 23, Suite 4, Butler, NJ 07405-1732 | 2011-06-28 |
| 1811295496 | Anderson Physician Alliance, Inc | Family Medicine | 522 E Pushmataha St, Butler, AL 36904-2628 | 2011-03-07 |
| 1447487996 | Darren Machak | Family Medicine | 1022b N Main Street, Butler, PA 16001-1954 | 2009-06-11 |
| 1598962581 | John Phillip Bustle | Family Medicine | 615 W Nursery, Butler, MO 64730 | 2007-07-02 |
| 1487739314 | Louis Keith Guinn | Family Medicine | 315 E Pushmataha St, Butler, AL 36904-0678 | 2006-10-26 |
| 1427147503 | Lawrence J Zelonis | Family Medicine | 1610 N Main Street Ext, Butler, PA 16001-1513 | 2006-10-12 |
| 1255423570 | Family Medicine of Butler P C | Family Medicine | 1022a North Main St, Butler, PA 16001 | 2006-09-28 |
| 1144320003 | Complete Care Family Medicine | Family Medicine | 357 N Main St, Butler, PA 16001-4917 | 2006-09-22 |
| 1639284243 | Sheila Balestrino | Family Medicine | 342 North Main St, Butler, PA 16001 | 2006-08-21 |
| 1144335738 | Thippeswamy T. Channapati | Family Medicine | 342 North Main Street, Butler, PA 16001 | 2006-08-21 |
| Find all providers in BUTLER | ||||
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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.