KENNETH WAYNE ROACH (NPI# 1922561745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922561745 |
| Entity Type | Individual |
| Full Name | KENNETH WAYNE ROACH |
| Practice Address |
15650 Walden Rd Apt 4302 Montgomery TX 77356-1780 |
| Mailing Address |
3030 E 29th St Ste 102 Bryan TX 77802-2740 |
| Practice Telephone | 9035713332 |
| Mailing Telephone | 9797043258 |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619189628 | Kenneth David Roach | Counselor | 4190 S Highland Dr Ste 210, Salt Lake City, UT 84124-2674 | 2007-05-03 |
| 1780686014 | Kenneth William Roach | Ophthalmology | 1000 N Main St, Suite #204, Fuquay Varina, NC 27526-2056 | 2005-05-31 |
| 1053630673 | Kenneth Lee Roach | Internal Medicine | 3300 Gallows Road, Department of Medicine, Falls Church, VA 22042 | 2010-05-21 |
| Street Address |
15650 WALDEN RD APT 4302 |
| City | MONTGOMERY |
| State | TX |
| Zip Code | 77356-1780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952919490 | Age Well Concierge Medicine | Family Medicine | 18441 Tx-105, Suite B, Montgomery, TX 77356 | 2020-07-21 |
| 1912549908 | Kindra Siewood | Speech-Language Pathologist | 15320 Tx-105 W, Suite 116, Montgomery, TX 77356 | 2019-10-11 |
| 1710545595 | Vaughn Motley Bryant IIi | Counselor | 14740 Liberty Street, Montgomery, TX 77356 | 2019-06-05 |
| 1871157420 | Belinda Kay Warren Delapena | Counselor | 3507 Whittier, Montgomery, TX 77356 | 2019-04-30 |
| 1841760071 | Cvs Pharmacy Inc | Pharmacy | 20125 Eva Street, Montgomery, TX 77356 | 2018-11-30 |
| 1750863429 | Kristina Lynn Knighten | Specialist/Technologist | 3602 Woodland Lane, Montgomery, TX 77356 | 2018-08-30 |
| 1770072415 | Crosby Pharmacy & Wellness, LLC | Pharmacy | 18446 Tx - 105 Ste D, Montgomery, TX 77356 | 2018-05-08 |
| 1760999726 | Everbright Dental Pllc | Dentist | 20212 Eva St., #160, Montgomery, TX 77356 | 2017-12-29 |
| 1821535261 | Ramon Campbell | Nurse Practitioner | 108 Harbour Town Drive, Montgomery, TX 77356 | 2017-01-24 |
| 1447628995 | Erica Everett | Nurse Practitioner | 110 April Wind Ct, Montgomery, TX 77356 | 2015-09-14 |
| Find all providers in zip 77356 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013428580 | Larry Dell Turner | Specialist | 600 S Court St Ste 312, Montgomery, AL 36104-4106 | 2017-10-23 |
| 1881042760 | Hairzone | Specialist | 3009 Mcgehee Rd, B, Montgomery, AL 36111-2202 | 2016-06-01 |
| 1043675051 | Robert Wareham | Specialist | 105 Forest Wind Cir, Montgomery, TX 77316-6846 | 2015-12-17 |
| 1497129159 | Annail Reese Fort | Specialist | 3009b Mcgehee Rd, Montgomery, AL 36111-2202 | 2015-11-18 |
| 1699155721 | Maryethel Nutt | Specialist | 53 Quarry Rd, Montgomery, NY 12549-2524 | 2015-06-03 |
| 1225421274 | Next Level Healthcare Consultants LLC | Specialist | 47 S Wind Dr, Montgomery, TX 77356-8232 | 2015-03-16 |
| 1710388483 | Yolanda Flynn | Specialist | 3957 Kimberly St, Montgomery, AL 36116-4515 | 2014-09-11 |
| 1366864647 | Rushmore Surgical Assistants | Specialist | 10906 Scenic Dr, Montgomery, TX 77356-5795 | 2014-01-06 |
| 1538503305 | Committed To Assisting Professionals | Specialist | 12002 Brightwood Dr, Montgomery, TX 77356-7920 | 2013-04-24 |
| 1366719098 | Carla Trina Vitek | Specialist | 10 Montgomery Hts, Montgomery, NY 12549-2500 | 2011-11-23 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 77356 |
Please comment or provide details below to improve the information on KENNETH WAYNE ROACH.
| 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.