IAN C MUNGER (NPI# 1023247723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023247723 |
| Entity Type | Individual |
| Full Name | IAN C MUNGER |
| Credential | DO |
| Practice Address |
1497 Fair Rd Statesboro GA 30458-0822 |
| Mailing Address |
1176 Brampton Ave Statesboro GA 30458-0847 |
| Practice Telephone | 9124861111 |
| Mailing Telephone | 9122599474 |
| Mailing Fax Number | 9122255719 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2020-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 070661 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | R-8762 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0230169 | 05 |
| Street Address |
1497 FAIR RD |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-0822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952380768 | Karen Renea Hilde | Nurse Practitioner | 1497 Fair Rd, Suite 200, Statesboro, GA 30458-0822 | 2006-01-10 |
| 1508393208 | Neurology and Neurodiagnostic LLC | Psychiatry & Neurology | 1497 Fair Rd, Statesboro, GA 30458-0822 | 2017-05-12 |
| 1720341514 | Bulloch Pediatrics Group, LLC | Nurse Practitioner | 1497 Fair Rd, Suite 200, Statesboro, GA 30458-0822 | 2012-06-18 |
| 1114291051 | Clare D Heidler Iv | Registered Nurse | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0822 | 2012-02-23 |
| 1942591482 | Kathryn Winn Marucco | Nurse Practitioner | 1497 Fair Rd, Suite 200, Statesboro, GA 30458-0822 | 2011-05-02 |
| 1487983151 | East Georgia Hma Physician Management, LLC | Surgery | 1497 Fair Rd, Statesboro, GA 30458-0822 | 2009-12-09 |
| 1760627699 | Stattesboro Orthopaedic Center, Inc | Orthopaedic Surgery | 1497 Fair Rd, Ste 101, Statesboro, GA 30458-0823 | 2008-12-05 |
| 1679775712 | Bulloch Pediatrics, PC | Pediatrics | 1497 Fair Rd, Ste 200, Statesboro, GA 30458-0822 | 2007-06-01 |
| 1043352958 | Cesar Clinic, LLC | Specialist | 1497 Fair Rd, Suite 201, Statesboro, GA 30458-0822 | 2007-02-14 |
| 1700947231 | Kashyap Patel | Psychiatry & Neurology | 1497 Fair Rd, Suite 201, Statesboro, GA 30458-0822 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003011958 | James Daniel Weathers | Emergency Medicine | 213 Savannah Ave, Statesboro, GA 30458-2001 | 2007-06-20 |
| 1790731628 | Scott T. Pottratz | Emergency Medicine | 1499 Fair Rd, Statesboro, GA 30458-1683 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081657 | Rtw Health Services LLC | Emergency Medicine | 1951 Lenox Rd Ne, Atlanta, GA 30306-3059 | 2020-10-21 |
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1275141467 | Viral Solutions LLC | Emergency Medicine | 1752 Moonstone Ct, Decatur, GA 30033-1411 | 2020-07-14 |
| 1376102830 | John Edward Cooke | Emergency Medicine | 2411 Tuxedo Ln Nw, Marietta, GA 30064-1898 | 2019-06-10 |
| 1538646526 | Edwige Goby Konwo-tayo | Emergency Medicine | 1183 S Hairston Rd Ste A, Stone Mountain, GA 30088-2796 | 2018-07-23 |
| 1548763899 | South Georgia Er Services, LLC | Emergency Medicine | 313 Carrick Way, Macon, GA 31210-4952 | 2018-03-13 |
| 1922517945 | Infinity Wellness Solutions LLC | Emergency Medicine | 3240 Pointe Parkway, Suite 100, Norcross, GA 30092 | 2017-09-21 |
| 1528594314 | Kendra Chantelle Krieg | Emergency Medicine | 185 Anniversary Ln, Acworth, GA 30102 | 2017-05-11 |
| 1114450806 | Peyton Jones Syed | Emergency Medicine | 13765 Brittle Rd, Alpharetta, GA 30004-3592 | 2017-04-10 |
| 1437690658 | Miles Anthony Medina | Emergency Medicine | 1133 Eagles Landing Pkwy # Er, Stockbridge, GA 30281-5085 | 2017-03-20 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
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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.