RENAISSANCE PLASTIC SURGERY (NPI# 1063604791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063604791 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE PLASTIC SURGERY |
| Practice Address |
4030 Riverside Park Blvd Macon GA 31210-1365 |
| Practice Telephone | 4784742200 |
| Practice Fax Number | 4783140740 |
| Mailing Telephone | 4784742200 |
| Mailing Fax Number | 4783140740 |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |
| Authorized Official Name | MRS. KATHY STUART (ADMINISTRATOR) |
| Authorized Official Telephone | 4784742200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750508495 | Renaissance Plastic Surgery | Surgery | 6105 Windcom Ct, Suite 150, Plano, TX 75093 | 2007-04-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | RENAISSANCE PLASTIC SURGERY, PLLC | P.o. Box 220424, Great Neck, Ny 11022 |
| Street Address |
4030 RIVERSIDE PARK BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31210-1365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912905050 | Roy Powell | Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1365 | 2005-07-12 |
| 1255582623 | Maximus Anesthesia Services LLC | Nurse Anesthetist, Certified Registered | 4030 Riverside Park Blvd, Macon, GA 31210-1365 | 2008-10-03 |
| 1497718258 | Paul John Syribeys | Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1365 | 2006-04-11 |
| 1427056647 | Christopher L Mclendon | Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1365 | 2005-07-12 |
| 1396743514 | Renaissance Surgical Centre, LLC | Clinic/Center | 4030 Riverside Park Blvd, Macon, GA 31210-1365 | 2005-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427528843 | Professional Medical Coding & Billing | Specialist | 105 George Oxford Dr, Macon, GA 31220-8907 | 2018-11-28 |
| 1568831295 | Demetrice Lashay Harris | Specialist | 750 Riverside Drive Ln Ste 160, Macon, GA 31201-2669 | 2015-09-23 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1265796601 | Dana Carries | Specialist | 1760 Bass Rd Ste 102, Macon, GA 31210 | 2012-06-29 |
| 1699096388 | Harry Frances Moore Jr. | Specialist | 800 First Street, Suite 410, Central Georgia Cancer Center, PC, Macon, GA 31201-8300 | 2010-06-16 |
| 1508025735 | Georgia Dialysis Access Center PC | Specialist | 889 2nd St, Macon, GA 31201-6862 | 2008-06-03 |
| 1992987358 | Maria Fondal | Specialist | Suite 1000, 6501 Peake Road, Macon, GA 31210 | 2007-11-28 |
| 1194927251 | Elka Jeanine Wiley | Specialist | 380 Hospital Dr Ste 370, Macon, GA 31217-8010 | 2007-06-01 |
| 1770784100 | Ahmad Al-hajj | Specialist | 800 First Street, Suite 410, Macon, GA 31201-8300 | 2007-05-31 |
| 1902935281 | Southeastern Surgery & Sleep Apnea Treatment Ctr. LLC | Specialist | 3333 Northside Drive, Suite B, Macon, GA 31210-2590 | 2007-03-05 |
| Find all providers in MACON | ||||
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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.