PAUL B LANDRY III (NPI# 1477599892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477599892 |
| Entity Type | Individual |
| Full Name | PAUL B LANDRY III |
| Credential | PAC |
| Practice Address |
310 N State of Franklin Rd Suite 101 Johnson City TN 37604-6008 |
| Practice Telephone | 4239297393 |
| Practice Fax Number | 4239290872 |
| Mailing Telephone | 4239297393 |
| Mailing Fax Number | 4239290872 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2017-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1603 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1603 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1506078 | 05 | |
| TN | RAILROAD MEDICARE | P00686005 | 01 |
| VA | 1477599892 | 05 | |
| TN | BC/BS | 4190518 | 01 |
| KY | 7100095460 | 05 | |
| TN | JOHN DEERE | TN01 UW | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730797580 | Paul Taylor Landry | Optometrist | 3007 Peekskill Ct, Pearland, TX 77584-4950 | 2020-07-17 |
| 1902897523 | Paul R. Landry | Internal Medicine | 2911 Riverview Blvd, Bradenton, FL 34205-3418 | 2005-11-02 |
| 1124032891 | Paul R Landry | Social Worker | 4000 E Charleston Blvd, Suite 230, Las Vegas, NV 89104-6659 | 2006-07-28 |
| Street Address |
310 N STATE OF FRANKLIN RD SUITE 101 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769903 | Pamela L. Greer | Nurse Practitioner | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| 1659817377 | Shandon Morrison | Nurse Practitioner | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2017-01-19 |
| 1366990442 | Michelle L Jones | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-09-16 |
| 1881147692 | Deretsa Perry | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-07-28 |
| 1053762112 | Blue Ridge Medical Management Corporation | Internal Medicine | 310 N State of Franklin Rd, Ste 301a, Johnson City, TN 37604-6008 | 2016-06-29 |
| 1669864377 | Emily Kathleen Price | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2015-03-04 |
| 1366862336 | Miranda Kyker | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2014-04-17 |
| 1114340445 | Blue Ridge Medical Management | Surgery | 310 N State of Franklin Rd, Suite 101b, Johnson City, TN 37604-6008 | 2014-01-22 |
| 1225389349 | Trinity Cancer Care, P.C. | Internal Medicine | 310 N State of Franklin Rd, Suite 401, Johnson City, TN 37604-6073 | 2012-09-28 |
| 1285936930 | Ryan Kara Judson | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2010-12-01 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821616590 | Brenda L Rankhorn | Physician Assistant | 402 Brookwood Dr, Johnson City, TN 37615-4924 | 2020-07-09 |
| 1336706183 | Andrew Thomas Rogers | Physician Assistant | 401 E Watauga Ave, Johnson City, TN 37601-4036 | 2019-05-28 |
| 1750859831 | Bethany Marie Zakrzewski | Physician Assistant | 410 N State of Franklin Rd Ste 120, Johnson City, TN 37604-6972 | 2018-11-07 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1417453440 | Blue Ridge Medical Management Corpoartion | Physician Assistant | 701 Med Tech Pkwy Ste 300, Johnson City, TN 37604-2365 | 2018-03-30 |
| 1083082838 | Amber Dykes | Physician Assistant | 119 Boone Ridge Dr Ste 201, Johnson City, TN 37615-8000 | 2015-09-10 |
| 1720336712 | Amy C Flint | Physician Assistant | 303 Med Tech Pkwy Ste 150, Johnson City, TN 37604-2394 | 2012-08-22 |
| 1568779155 | Tracy Mcwhorter Martino | Physician Assistant | 3 Professional Park Dr Ste 21, Johnson City, TN 37604-6529 | 2010-09-03 |
| 1932430741 | Lisa M Adams | Physician Assistant | 1301 Sunset Drive, Suite 3, Johnson City, TN 37604 | 2010-01-18 |
| 1265594618 | Whitney Diane Davis | Physician Assistant | 2514 Wesley St Ste 102, Johnson City, TN 37601-1764 | 2006-12-14 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on PAUL B LANDRY III.
| 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.