Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164425831 Individual Practitioner Male Practitioner

Dr. John M. Roach , MD

Pediatrics • Paducah, KY

Professional Overview & Biography Verified Profile Summary

Dr. John Roach, MD is a registered healthcare professional specializing in Pediatrics in Paducah, KY. Practice services are available at 242 BERGER RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

242 Berger Rd

Paducah, KY 420034522

Telephone 2703660960
Fax 2715541108
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Paducah, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 47.0 Yrs
State Avg: 19.3 Yrs
Regional Practice Density
12 Specialists

Practicing in Paducah, KY (910 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-15
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License KY 39216

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
64095565 (KY)
Commercial Insurance / Payer ID Ky State License
39216 (KY)
Commercial Insurance / Payer ID Npi Group
1427478700 (KY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Sheena Felts , APRN

Nurse Practitioner - Family

NPI 1417671041

Advanced Practice Registered Nurse

Kathy Olson , APRN

Nurse Practitioner - Family

NPI 1912270125

Advanced Practice Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Business Mailing Address September 27, 2024

Registered at 242 BERGER RD, PADUCAH, KY 420034522 (Tel: 2703660960)

📍
Updated Practice Location October 08, 2019

Registered at 242 BERGER RD, PADUCAH, KY 420034522 (Tel: 2703660960)

NPI Profile Active September 18, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 18, 2017

Registered at 4645 VILLAGE SQUARE DR, SUITE C, PADUCAH, KY 420017448 (Tel: 2709999999)

📍
Updated Business Mailing Address September 18, 2017

Registered at 4645 VILLAGE SQUARE DR, SUITE C, PADUCAH, KY 420017448

👤
Provider Name / Credentials Updated September 18, 2017

Recorded as JOHN ROACH, M.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 18, 2017

Pediatrics (License #39216 in KY)

NPI Profile Active April 25, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location April 25, 2014

Registered at 4645 VILLAGE SQUARE DR, SUITE C, PADUCAH, KY 420017448 (Tel: 2709999999)

📍
Updated Business Mailing Address April 25, 2014

Registered at 4645 VILLAGE SQUARE DR, SUITE C, PADUCAH, KY 420017448

👤
Provider Name / Credentials Updated April 25, 2014

Recorded as JOHN ROACH, M.D

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2014

Pediatrics (License #39216 in KY)

🟢
Initial NPI Registration & Enumeration May 24, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164425831
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2005
Last Update: October 15, 2024
Sole Proprietor: Yes

Mailing Address

242 Berger Rd

Paducah, KY 420034522

Phone: 2703660960

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.