MRS. CAITLEN M PETSCHKE (NPI# 1558669986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558669986 |
| Entity Type | Individual |
| Full Name | MRS. CAITLEN M PETSCHKE |
| Credential | PA-C |
| Practice Address |
101 Med Tech Pkwy Ste. 405 Johnson City TN 37604-4007 |
| Practice Telephone | 4239292452 |
| Practice Fax Number | 4239292531 |
| Mailing Telephone | 4239292452 |
| Mailing Fax Number | 4239292531 |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2013-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2275 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA200351 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2158848 | 05 |
| Street Address |
101 MED TECH PKWY STE. 405 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-4007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205830536 | Fernando Bendfeldt | Psychiatry & Neurology | 101 Med Tech Pkwy, Ste 407, Johnson City, TN 37604-4000 | 2005-05-23 |
| 1023319290 | John Argerson | Specialist | 101 Med Tech Pkwy, Suite 402, Johnson City, TN 37604-4007 | 2010-11-04 |
| 1962655696 | Pain Medicine Associates, P.C. | Psychologist | 101 Med Tech Pkwy, Suite 200, Johnson City, TN 37604-4007 | 2008-10-28 |
| 1679722052 | Michael M Wilkinson | Anesthesiology | 101 Med Tech Pkwy, Johnson City, TN 37604-4007 | 2008-09-10 |
| 1548422355 | Pma Surgery Center LLC | Psychologist | 101 Med Tech Pkwy, Suite 205, Johnson City, TN 37604-4007 | 2008-07-02 |
| 1942475439 | Tri Cities Esthetics, Inc. | Specialist | 101 Med Tech Pkwy, Suite 402, Johnson City, TN 37604-4007 | 2008-04-25 |
| 1821158031 | Alison Repass Herrig | Nurse Practitioner | 101 Med Tech Pkwy, Suite 405, Johnson City, TN 37604-4007 | 2006-12-11 |
| 1053496901 | Mountain States Health Alliance | Durable Medical Equipment & Medical Supplies | 101 Med Tech Pkwy, Suite 100, Johnson City, TN 37604-4007 | 2006-10-26 |
| 1417031071 | Smokie Mountain Dialysis Inc. | Clinic/Center | 101 Med Tech Pkwy, Suite 406, Johnson City, TN 37604-4007 | 2006-10-24 |
| 1922191238 | James A Ross | Emergency Medicine | 101 Med Tech Pkwy, Suite 305, Johnson City, TN 37604-4007 | 2006-10-02 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083965651 | Shalena Peterson | Physician Assistant | 301 Med Tech Pkwy Ste 280, Johnson City, TN 37604-2364 | 2012-09-24 |
| 1063544716 | Christine Turbyfill Kinley | Physician Assistant | 3741 W Market St, Johnson City, TN 37604 | 2007-03-09 |
| 1508877416 | Pamela B Davis | Physician Assistant | 1627 Old Gray Station Rd, Ste 4, Johnson City, TN 37615-4193 | 2006-08-10 |
| 1437166477 | Thomas Alan Frantzen | Physician Assistant | Corner of Sidney and Lamont Streets, Johnson City, TN 37684-4000 | 2006-08-02 |
| 1700828977 | Melvin James Willis | Physician Assistant | James H Quillen/va Medical Center, Coner of Sidney & Lamont, Johnson City, TN 37684 | 2006-06-12 |
| 1902888944 | Bryan Daniel Lorch | Physician Assistant | 2514 Wesley St, 102, Johnson City, TN 37601-1764 | 2005-11-16 |
| 1386268159 | James Owen Thigpen | Physician Assistant | 410 N State of Franklin Rd Ste 130, Johnson City, TN 37604-6972 | 2020-06-08 |
| 1841814803 | Anthony Brian Jones | Physician Assistant | 2428 Knob Creek Rd Ste 102, Johnson City, TN 37604-2396 | 2020-06-04 |
| 1790319317 | Frances Wilson | Physician Assistant | 401 E Watauga Ave, Johnson City, TN 37601-4036 | 2020-02-24 |
| 1841741196 | Grace Internal Medicine, LLC | Physician Assistant | 2514 Wesley St, Suite 102, Johnson City, TN 37601-1764 | 2016-10-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on MRS. CAITLEN M PETSCHKE.
| 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.