DR. JOHN JOSEPH KONIKKARA (NPI# 1962664011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962664011 |
| Entity Type | Individual |
| Full Name | DR. JOHN JOSEPH KONIKKARA |
| Credential | MD |
| Practice Address |
1615 Delaware St Longview WA 98632-2367 |
| Mailing Address |
8157 Southwestern Blvd Apartment# 142 Dallas TX 75206-2019 |
| Practice Telephone | 3604147800 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2017-04-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD60704069 | WA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD60704069 | WA | Allopathic & Osteopathic Physicians |
| Y | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
MD60704069 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2070508 | 05 |
| Street Address |
1615 DELAWARE ST |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 2084S0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Sleep Medicine |
| A Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154611010 | Yujean Han | Psychiatry & Neurology | 1145 Broadway Fl 2, Seattle, WA 98122 | 2011-04-12 |
| 1215255468 | Andrew Lynn Hong | Psychiatry & Neurology | 501 Se 172nd Ave # 220, Vancouver, WA 98684-9542 | 2010-05-12 |
| 1467664631 | Jefferson County Public Hospital District No 2 | Psychiatry & Neurology | 9833 Poplars Ave Nw Ste 104, Silverdale, WA 98383-7675 | 2007-05-03 |
| 1164420428 | Morris B Chang | Psychiatry & Neurology | 550 17th Ave, Seattle, WA 98122-5788 | 2005-07-11 |
| 1003430604 | Sleep Health Clinic Pllc | Psychiatry & Neurology | 2501 Ne 134th St Ste 203, Vancouver, WA 98686-3028 | 2020-05-31 |
| 1730421157 | Catherine Mccall | Psychiatry & Neurology | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2013-03-24 |
| 1467725226 | Pinnacle Sleep & Wake Disorders Center Pllc | Psychiatry & Neurology | 1446 Spaulding Park, Ste. 301, Richland, WA 99352-4707 | 2012-02-09 |
| 1245485291 | Michael E Coats Md Pllc | Psychiatry & Neurology | 5633 N Lidgerwood St, Spokane, WA 99208-1224 | 2008-11-18 |
| 1295907566 | Brandon Richard Peters Mathews | Psychiatry & Neurology | 1100 9th Ave, Seattle, WA 98101-2756 | 2008-03-27 |
| 1578777355 | Meredith Broderick | Psychiatry & Neurology | 1100 112th Ave Ne, Suite 320, Bellevue, WA 98004-4511 | 2007-05-10 |
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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.