CENTRAL GEORGIA INTERNIST (NPI# 1114034758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114034758 |
| Entity Type | Organization |
| Organization Name | CENTRAL GEORGIA INTERNIST |
| Practice Address |
657 Hemlock St Ste 220 Macon GA 31201-8329 |
| Practice Telephone | 4787417241 |
| Mailing Telephone | 4787417241 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MUFID A OTHMAN (PRESIDENT) |
| Authorized Official Telephone | 4787417241 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
657 HEMLOCK ST STE 220 |
| City | MACON |
| State | GA |
| Zip Code | 31201-8329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134172588 | Iris Chambliss Kelly | Internal Medicine | 657 Hemlock St, Suite 220, Macon, GA 31201-8329 | 2006-05-18 |
| 1336611714 | Heather Nicole Self | Registered Nurse | 657 Hemlock St, Macon, GA 31201-8329 | 2018-12-22 |
| 1184173965 | Ivy Vickers | Nurse Practitioner | 657 Hemlock St, Suite 220, Macon, GA 31201 | 2016-09-22 |
| 1487002382 | Magna Care Medical Specialists LLC | Hospitalist | 657 Hemlock St, Ste 220, Macon, GA 31201-8329 | 2016-06-01 |
| 1770958589 | Mary Gayle Schnee | Nurse Practitioner | 657 Hemlock St, Macon, GA 31201-8329 | 2015-12-04 |
| 1588087142 | Seolhyun Lee | Internal Medicine | 657 Hemlock St, Ste 220, Macon, GA 31201-8329 | 2014-01-31 |
| 1487774303 | Ihab Zaki Zaggout | Internal Medicine | 657 Hemlock St, Suite 200, Macon, GA 31201-8329 | 2007-04-02 |
| 1790827129 | Magna Intensive Care LLC | Specialist | 657 Hemlock St, Ste 220, Macon, GA 31201-8329 | 2007-02-13 |
| 1750464145 | Robbie D James | Dietitian, Registered | 657 Hemlock St, Suite 100, Macon, GA 31201-8329 | 2006-10-23 |
| 1578573762 | Christy R Johnson | Nurse Practitioner | 657 Hemlock St, Suite 220, Macon, GA 31201-8329 | 2006-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
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| 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 |
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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.