Provider Demographics
NPI:1679795256
Name:ROME, RACHEL C (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:ROME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 HIGH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-6300
Mailing Address - Country:US
Mailing Address - Phone:270-881-4150
Mailing Address - Fax:270-881-4151
Practice Address - Street 1:1717 HIGH ST STE 3B
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-6300
Practice Address - Country:US
Practice Address - Phone:270-881-4150
Practice Address - Fax:270-881-4151
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD47701207L00000X
VA0101248404207L00000X
TN47701208VP0014X
TN49763208VP0014X
KY49763208VP0014X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6061219OtherBCBS
TN1525558Medicaid
KY7100233930Medicaid
KY7100233930Medicaid