MR. JEROME A MAISLIS (NPI# 1043311376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043311376 |
| Entity Type | Individual |
| Full Name | MR. JEROME A MAISLIS |
| Credential | PA-C |
| Practice Address |
2400 Mt. Zion Parkway Kaiser Permanente Southwood Comprehensive Medical Cente Jonesboro GA 30236 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7706033649 |
| Mailing Telephone | 4043647070 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2015-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
002464 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2400 MT. ZION PARKWAY KAISER PERMANENTE SOUTHWOOD COMPREHENSIVE MEDICAL CENTE |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508866153 | Jodi Bayley Baptiste | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2005-07-26 |
| 1013450816 | Dorothy Delisfort-crisostomo | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehension Medical Offic, Jonesboro, GA 30236 | 2016-11-28 |
| 1639590136 | Ashley Christine Ziobrowski | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-12-31 |
| 1730520321 | Nash Ditmetaroj | Optometrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-07-10 |
| 1770927402 | Labrittany R Davis-farve | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-24 |
| 1477896645 | Fofie S Akoto | Internal Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-05 |
| 1265773584 | Karen Kelly Willard | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-03-12 |
| 1114264652 | Jaclyn Marie Schwartz | Podiatrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-01-03 |
| 1801144605 | Dorie Angela Saxon | Pediatrics | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-08-28 |
| 1689937880 | Meena Yasmeen | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184250805 | Ashley Elizabeth Mclean | Physician Assistant | 225 E Washington Ave, Jonesboro, AR 72401-3111 | 2020-03-13 |
| 1063968022 | Rebecca Mcphail | Physician Assistant | 7823 Spivey Station Blvd, Jonesboro, GA 30236-2886 | 2016-08-30 |
| 1548629090 | Adam Lawson | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2016-02-12 |
| 1366801870 | Kirk Porter | Physician Assistant | 1107 E Matthews Ave, Suite 200, Jonesboro, AR 72401-4315 | 2016-02-12 |
| 1326419789 | Mandy Katheryn Mcnamara | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2015-10-12 |
| 1598153157 | Drew Weldon Harper | Physician Assistant | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2015-01-06 |
| 1053650945 | Meredith Harrison Brewer | Physician Assistant | 800 S Church St Ste 203, Jonesboro, AR 72401 | 2013-02-12 |
| 1346587599 | Maranda Elizabeth Nichols | Physician Assistant | 4334 E Highland Dr, Ste A, Jonesboro, AR 72401-6621 | 2013-01-08 |
| 1194025536 | Linda Nguyen | Physician Assistant | 300 Carson St, Jonesboro, AR 72401-3104 | 2010-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
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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.