MITCHELL BOLES (NPI# 1003470402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003470402 |
| Entity Type | Individual |
| Full Name | MITCHELL BOLES |
| Credential | APRN |
| Practice Address |
1665 Highway 34 E Ste 100 Newnan GA 30265-2404 |
| Practice Telephone | 7702527557 |
| Mailing Telephone | 7702527557 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN233677 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1975 Highway 54 W Ste 100, Peachtree City, GA 302694794 | 6788885060 | |
| 303 Smith St Fl 2, Lagrange, GA 302402745 | 6788000099 |
| Street Address |
1665 HIGHWAY 34 E STE 100 |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770993792 | Daniel Thomas Sandlin | Pain Medicine | 1665 Highway 34 E Ste 100, Newnan, GA 30265-2404 | 2014-04-29 |
| 1356959175 | Daniel Hughes | Nurse Practitioner | 1665 Highway 34 E Ste 100, Newnan, GA 30265-2404 | 2020-07-17 |
| 1538678511 | Rachel Smith Ussery | Nurse Practitioner | 1665 Highway 34 E Ste 100, Newnan, GA 30265-2404 | 2017-09-22 |
| 1033594114 | Ashley Miller | Nurse Practitioner | 1665 Highway 34 E Ste 100, Newnan, GA 30265-2404 | 2015-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164081303 | Kristi Kimbler | Nurse Practitioner | 2326 Highway 34 E Ste 201, Newnan, GA 30265-1328 | 2019-06-11 |
| 1306395041 | Kristie Lynn Buchanan | Nurse Practitioner | 197 Sunny Brook Dr, Newnan, GA 30263-3369 | 2016-09-22 |
| 1710524764 | Omar S Ganzy | Nurse Practitioner | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2019-12-09 |
| 1801431333 | Nathan Garrett Duffey | Nurse Practitioner | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2019-11-07 |
| 1235782228 | Mary Catherine Waite | Nurse Practitioner | 745 Poplar Rd, Newnan, GA 30265-1618 | 2019-07-19 |
| 1417401720 | Kelsey Hammond Smith | Nurse Practitioner | 184b Jefferson Pkwy, Newnan, GA 30263-5822 | 2016-08-04 |
| 1386026151 | Julianne Baily | Nurse Practitioner | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2015-06-29 |
| 1215320692 | Tiearea T Sims | Nurse Practitioner | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2015-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032114 | Candace Buckley | Nurse Practitioner | 244 Ashland Dr, Woodstock, GA 30189-7161 | 2020-10-29 |
| 1679170740 | Jennifer Lassiter | Nurse Practitioner | 4116 Holley Rd., Lizella, GA 31052 | 2020-10-02 |
| 1891301164 | Tashoy Wallace | Nurse Practitioner | 121 Odyssey Turn, Conyers, GA 30012-3681 | 2020-09-21 |
| 1912513672 | Katherine Anne Sego | Nurse Practitioner | 4060 Rolling Meadows Ln, Watkinsville, GA 30677-3011 | 2020-09-18 |
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1588276505 | Sherron Johnson | Nurse Practitioner | 1980 Wrights Way, Jonesboro, GA 30236-7205 | 2020-08-20 |
| 1942811682 | Ashlee Renee Mack | Nurse Practitioner | 116 Slate Cir, Savannah, GA 31419-9681 | 2020-08-16 |
| 1467063610 | Rosa Maria Phillips | Nurse Practitioner | 649 Amicalola Woods Rd, Dawsonville, GA 30534-1205 | 2020-08-12 |
| 1508476581 | Jarvis Reese | Nurse Practitioner | 413 Tug Ct, Warner Robins, GA 31088-2134 | 2020-08-05 |
| 1750991790 | Akosua Frema Sarfo | Nurse Practitioner | 116 Ginkgo Ln, Grovetown, GA 30813-5392 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
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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.