WEST GEORGIA PATHOLOGY, LLC (NPI# 1003823196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003823196 |
| Entity Type | Organization |
| Organization Name | WEST GEORGIA PATHOLOGY, LLC |
| Other Organization Name | WGP |
| Practice Address |
705 Dixie St Attention: Pathology Department Carrollton GA 30117-3818 |
| Mailing Address |
11025 Rca Center Dr Suite 300 Palm Beach Gardens FL 33410-4269 |
| Practice Telephone | 6783059046 |
| Mailing Telephone | 5615145822 |
| Mailing Fax Number | 5616264530 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-07-02 |
| Authorized Official Name | MICHAEL C GRATTENDICK (VICE PRESIDENT) |
| Authorized Official Telephone | 5616265512 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WGP | Other Name - Individual/Organization |
| Street Address |
705 DIXIE ST ATTENTION: PATHOLOGY DEPARTMENT |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407848799 | Lawrence Brett Carter | Pharmacist | 705 Dixie St, Carrollton, GA 30117-3818 | 2005-08-22 |
| 1760007322 | Crystal Renee Grayson | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-06-10 |
| 1962025361 | Amanda Hasty Mcentyre | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1265055669 | Purdy Jackson | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1528681921 | Amanda Phillips Kranz | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1699396630 | Katherine Victoria White | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-04-30 |
| 1144866047 | Jennifer Tiffany Jiles | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-11-26 |
| 1750934733 | Tiffany Landry | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104479195 | Kim Rowell | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104478916 | Brandon Gabe Graves | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578196358 | Carlos M Torres Md Expert Pathology Consultation Servi | Pathology | 2840 Keller Springs Rd Ste 1104, Carrollton, TX 75006-4876 | 2020-02-19 |
| 1518160092 | Coastal Pathology, Inc. | Pathology | 3418 Midcourt Rd., Suite 118, Carrollton, TX 75006 | 2007-06-11 |
| 1598783565 | Carroll Pathology Group, P.C. | Pathology | 604 Dixie St, Carrollton, GA 30117-3817 | 2006-07-18 |
| 1780846683 | Neal Bradley Mccollum | Pathology | 705 Dixie St, Attn: Pathology Dept, Carrollton, GA 30117-3818 | 2008-07-01 |
| 1205859097 | David Rydzewski | Pathology | 705 Dixie St, Attn: Pathology Department, Carrollton, GA 30117-3818 | 2006-07-25 |
| 1477576270 | Lawrence Alligood | Pathology | 604 Dixie St, Carrollton, GA 30117-3817 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1700225760 | Robert John Nelms Jr. | Pathology | 107 Fairway Dr, Moultrie, GA 31768-6823 | 2013-06-22 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1902143589 | Lindsey Oreita Lowder | Pathology | 1968 Peachtree Rd Nw Bldg 774th, Atlanta, GA 30309-1281 | 2013-01-15 |
| 1184918476 | Stephen Alan Dayan | Pathology | 830 Johns Landing Way, Lawrenceville, GA 30045-6369 | 2011-06-03 |
| 1760793673 | Andrew Erling Johnsen | Pathology | 3248 Avalon Pkwy, Conyers, GA 30013-6320 | 2010-06-24 |
| 1497066518 | Charles Omar Wilson Jr. | Pathology | 175 Samaritan Way, Jasper, GA 30143 | 2010-06-23 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on WEST GEORGIA PATHOLOGY, LLC.
| 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.