DR. DAVID J ROACH (NPI# 1457795734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457795734 |
| Entity Type | Individual |
| Full Name | DR. DAVID J ROACH |
| Credential | M.D. |
| Practice Address |
100 Mallard Creek Rd Suite 406 Louisville KY 40207-5166 |
| Practice Telephone | 5028954607 |
| Practice Fax Number | 5028954586 |
| Mailing Telephone | 5028954607 |
| Mailing Fax Number | 5028954586 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2016-08-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | TP225 | KY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100310450 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699139535 | David Roach | Internal Medicine | 1959 Ne Pacific St Rm Bb-527, Box 356421, Seattle, WA 98195-6421 | 2016-04-06 |
| Street Address |
100 MALLARD CREEK RD SUITE 406 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-5166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285622779 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 100 Mallard Creek Rd, Suite 150, Louisville, KY 40207-4194 | 2005-10-10 |
| 1497130017 | Phyllis Eugenia Moore | Nurse Practitioner | 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-4194 | 2015-07-24 |
| 1104213388 | Chad C Lanphear | Anesthesiologist Assistant | 100 Mallard Creek Rd, Louisville, KY 40207-4194 | 2015-04-24 |
| 1598163958 | Paige Faye Eggers | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2014-12-16 |
| 1407271562 | Brittney Leigh Porter | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2014-02-26 |
| 1548691876 | Heath Webb Perkins | Registered Nurse | 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 | 2013-12-12 |
| 1184066474 | Alison Elizabeth Hewett | Nurse Practitioner | 100 Mallard Creek Rd, Ste. 320, Louisville, KY 40207-4194 | 2013-07-27 |
| 1831434505 | Lori Sexton | Specialist/Technologist, Other | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2012-12-06 |
| 1790020469 | Hanna Vaughn | Specialist/Technologist, Other | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2012-12-06 |
| 1639414303 | Tina Pennington | Specialist/Technologist, Other | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2012-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316332448 | Christopher Fenzel | Emergency Medicine | 1850 Bluegrass Avenue, Louisville, KY 40215 | 2015-04-06 |
| 1477963163 | Tiffany A Campbell | Emergency Medicine | 530 South Jackson St., #c1h17, Louisville, KY 40202 | 2014-05-02 |
| 1154748382 | Samuel Rume Aya | Emergency Medicine | 530 South Jackson St, #c1h17, Department of Emergency Medicine, Louisville, KY 40202 | 2014-03-26 |
| 1598039315 | Mary Barbara Sowers | Emergency Medicine | 611 Emery Rd, Louisville, KY 40206 | 2012-02-24 |
| 1821383944 | Shaun M Reynolds | Emergency Medicine | 530 S Jackson St # C1h17, Department of Emergency Medicine, U of Louisville, Louisville, KY 40202-1675 | 2011-06-16 |
| 1497071674 | Jordan Taylor Brown | Emergency Medicine | 10904 Keene Rd, Louisville, KY 40241-4860 | 2010-04-14 |
| 1366679342 | Devin Sandlin | Emergency Medicine | 1907 Stevens Ave, Louisville, KY 40205-1048 | 2009-06-17 |
| 1801023320 | Mark Timothy Scallon Rukavina | Emergency Medicine | 2400 Mellwood Ave, Apt 1003, Louisville, KY 40206-1061 | 2009-06-11 |
| 1962664961 | Amy Lynn Minix | Emergency Medicine | 3504 Birchmore Pl, Louisville, KY 40245-8475 | 2008-06-30 |
| 1912169673 | Valerie King | Emergency Medicine | 2779 Maple Rd, Louisville, KY 40205-1735 | 2008-06-25 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.