84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA. (NPI# 1124062112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124062112 |
Entity Type | Organization |
Organization Name | 84PEDIATRIX MEDICAL GROUP UNIVERSITY HOSPITAL AUGUSTA GA. |
Practice Address |
1350 Walton Way Augusta GA 30901-2629 |
Mailing Address |
4227 Quail Springs Cir Martinez GA 30907-4610 |
Practice Telephone | 7067748948 |
Mailing Telephone | 7068634975 |
Enumeration Date | 2006-06-16 |
Last Update Date | 2008-06-13 |
Authorized Official Name | MRS. JOAN DANIEL HARPER (NEONATAL NURES PRACTITIONER) |
Authorized Official Telephone | 7067748948 |
Authorized Official Credential | NNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
RN042192 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1350 WALTON WAY |
City | AUGUSTA |
State | GA |
Zip Code | 30901-2629 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811993926 | Mary Jo Goolsby | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2005-06-23 |
1750989810 | Trang Khanh Nguyen | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2629 | 2020-10-12 |
1245842152 | Margaret Anne Rossi | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2020-08-21 |
1003445313 | Sarika Mishra | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2020-04-07 |
1508491812 | Kyle Guderian | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2020-03-06 |
1982246070 | Aisha Ford | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-10-10 |
1588214977 | Alexander S Elsen | Physical Medicine & Rehabilitation | 1350 Walton Way, Augusta, GA 30901-2629 | 2019-09-17 |
1215599527 | Sherwin Goering | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-07-08 |
1417418807 | Christopher Brandon Walker | Student in an Organized Health Care Education/Training Program | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-03-27 |
1205309333 | Rachel Ann Shaver | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2629 | 2019-01-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
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Taxonomy Code | 363LN0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Neonatal |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811252919 | Vicky T Kramer | Nurse Practitioner | 15707 Sw Us Hwy 77, Augusta, KS 67010 | 2012-07-05 |
1912419151 | Emmie Norville Park | Nurse Practitioner | 1120 15th St # 6033, Augusta, GA 30912-0004 | 2017-10-27 |
1902273261 | Mary Ellen Thompson | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2015-08-21 |
1306261441 | April Reid Grant | Nurse Practitioner | 1120 15th St, Suite Number Bi6033, Augusta, GA 30912-0004 | 2014-02-26 |
1992027205 | Kristi Thomas Norman | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-3715 | 2010-02-28 |
1114137619 | Ashley Hardy Bartley | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2007-05-23 |
1285786574 | Rhonda L. Holton | Nurse Practitioner | 1350 Walton Way, 3rd Floor, Augusta, GA 30901-2612 | 2007-01-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265944896 | Jennifer Michelle Kerhin | Nurse Practitioner | 777 Hemlock St Fl 3, Macon, GA 31201-2102 | 2017-11-05 |
1871034587 | Stephanie Joseph | Nurse Practitioner | 4316 Sublime Trl, Atlanta, GA 30349-8882 | 2017-03-14 |
1659810935 | Stephanie Gale Devers | Nurse Practitioner | 52 Johnny Wortham Rd, Newnan, GA 30263-4823 | 2017-02-19 |
1851757520 | Dawn Michelle Tripp | Nurse Practitioner | 10141 Flat Shoals Rd Sw, Covington, GA 30014-3707 | 2016-01-11 |
1295080414 | Christa Noel Brown | Nurse Practitioner | 142 Bryce Ryan Cir, Kingsland, GA 31548-7812 | 2012-07-14 |
1336398726 | Robin Domm Burch | Nurse Practitioner | 1790 Mulkey Rd Ste 10, Newborn Clinics of America LLC At Wellstar Cobb Clinic, Austell, GA 30106-1122 | 2008-09-10 |
1073730032 | Diane Arlene Doherty-chandler | Nurse Practitioner | 1191 Arbor Ln, Madison, GA 30650-3791 | 2007-04-19 |
1396886370 | Barbara Elaine Smith | Nurse Practitioner | 5335 Spot Creek Dr, Cumming, GA 30040-9554 | 2007-02-10 |
1245315118 | Sara Gelson Martin | Nurse Practitioner | 1762 Clifton Rd Ne Ste 103, Emory University, Atlanta, GA 30322-4001 | 2006-10-26 |
1861450058 | Paula Lynn Young | Nurse Practitioner | 2701 North Decatur Rd, Dekalb Medical Center, Decatur, GA 30033 | 2006-05-04 |
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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.