MICHELLE A ROSS (NPI# 1124006309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124006309 |
Entity Type | Individual |
Full Name | MICHELLE A ROSS |
Other Name | MICHELLE SHUBIN |
Credential | M.D. |
Practice Address |
1412 Milstead Ave Ne Conyers GA 30012-3877 |
Mailing Address |
Po Box 200096 Cartersville GA 30120-9002 |
Practice Telephone | 7709183000 |
Mailing Telephone | 6789057053 |
Mailing Fax Number | 6789057053 |
Enumeration Date | 2006-01-06 |
Last Update Date | 2019-01-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
045603 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000826856A | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487024451 | Michelle Ross | Occupational Therapy Assistant | 1606 Brooklyn Ave, 3rd Flr, Brooklyn, NY 11210-3427 | 2015-10-02 |
1568719201 | Michelle Ross | Nutritionist | 2915 Applewood Dr, Lodi, CA 95242-8318 | 2012-08-13 |
1922354018 | Michelle J Ross | Home Health | 1349 Brace Rd, Victor, NY 14564-9425 | 2012-07-26 |
1518234178 | Michelle Lorraine Ross | Speech-Language Pathologist | 36 Stone Ridge Dr, Oswego, NY 13126-7107 | 2011-11-28 |
1669704060 | Michelle Lee Ross | Behavioral Analyst | 14124 Hauser St, Overland Park, KS 66221-2842 | 2010-02-10 |
1356417679 | Michelle Ross | Speech-Language Pathologist | 10401 Ne Fourth Plain Rd, Suite 101, Vancouver, WA 98662-6308 | 2006-11-28 |
1629681218 | Michelle Doris Ross | Social Worker | 400 W Seventh St, Frederick, MD 21701-4506 | 2020-08-25 |
1518501626 | Michelle Yevon Ross | Counselor | 1090 E Cypress Ave, Redding, CA 96002-1163 | 2019-10-31 |
1215462098 | Michelle Ross | Behavioral Analyst | 10174 Old Grove Rd Ste 100, San Diego, CA 92131-1652 | 2017-04-28 |
1275948440 | Michelle Ross | Registered Nurse | 8033 E 10 Mile Rd, 114, Center Line, MI 48015-1427 | 2014-06-26 |
Street Address |
1412 MILSTEAD AVE NE |
City | CONYERS |
State | GA |
Zip Code | 30012-3877 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033191093 | Clifford N Grossman | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2005-11-16 |
1417570102 | Jonathan Stott | Registered Nurse | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2020-05-28 |
1104486711 | Tracie Theresa Edwards | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2019-06-17 |
1386116309 | Walker Lake Intensivist, PC | Physician Assistant | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2019-01-02 |
1437629342 | Walker Lake Emergency Group, PC | Physician Assistant | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-12-04 |
1003385964 | Walker Lake Physician Services, PC | Internal Medicine | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-11-20 |
1104328095 | Enas Basha | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-03-06 |
1306355680 | Piedmont Rockdale Hospital Inc. | General Acute Care Hospital | 1412 Milstead Ave Ne, Conyers, GA 30012 | 2017-09-29 |
1093254658 | Taylor Zahn Yengst | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2017-02-15 |
1285186452 | Shadae Mcmillan | Podiatrist | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-11-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
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Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
1861478588 | Mark Otto Bernardy | Radiology | 1031 Jimson Dr Se, Conyers, GA 30013-2064 | 2005-12-15 |
1033191093 | Clifford N Grossman | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2005-11-16 |
1508847328 | Northwest Diagnostic Imaging, Inc | Radiology | 2287 Salem Rd Se, Conyers, GA 30013-2025 | 2005-11-09 |
1376775403 | Open Mri of Georgia, Inc | Radiology | 2287 Salem Rd Se, Conyers, GA 30013-2025 | 2009-08-24 |
1174701262 | Bradley Lloyd Fricke | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2008-01-31 |
1700864972 | Richard Glen Stiles | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2006-01-06 |
1881676245 | Kristin H Lewis | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2005-11-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326650136 | Tbi Diagnostic Centers of Georgia | Radiology | 4294 Memorial Dr Ste D, Decatur, GA 30032-1226 | 2020-08-21 |
1912464702 | Vickie Consuella71 Bush | Radiology | 3701 Bermuda Run Dr, Valdosta, GA 31605-1059 | 2019-02-27 |
1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
1578061636 | Subspecialty Imaging, LLC | Radiology | 1495 Hickory Flat Hwy Ste 150, Canton, GA 30115-4229 | 2018-01-24 |
1205354693 | Zenith Radiology LLC | Radiology | 1059 Windermere Xing, Cumming, GA 30041-6104 | 2017-09-06 |
1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
1902346422 | Allegiance Imaging and Radiology LLC | Radiology | 900 Thornton Rd, Ste A, Lithia Springs, GA 30122-2641 | 2017-03-02 |
1518406743 | Flexogenix Georgia PC | Radiology | 4600 Roswell Rd Unit E210, Sandy Springs, GA 30342-3197 | 2017-02-21 |
1649727215 | Metro Imaging Cumming, LLC | Radiology | 4150 Deputy Bill Cantrell Memorial Road, Cumming, GA 30040 | 2016-09-01 |
1801250022 | Carolyn G. Dudley, Md, PC | Radiology | 956 Persimmon Pt, Sandy Springs, GA 30328-4503 | 2016-04-13 |
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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.