TLC OF GEORGIA LLC (NPI# 1124407440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124407440 |
| Entity Type | Organization |
| Organization Name | TLC OF GEORGIA LLC |
| Practice Address |
774 Ga Highway 96 Bonaire GA 31005-3300 |
| Mailing Address |
2620 Elm Hill Pike Nashville TN 37214-3108 |
| Practice Telephone | 4789885711 |
| Mailing Telephone | 6154254200 |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2016-12-21 |
| Authorized Official Name | MARC R WATKINS JR. (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 6154254200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164827853 | Tlc of Georgia LLC | Nurse Practitioner | 1931 Jesse Jewell Pkwy, Gainesville, GA 30501-2500 | 2014-10-24 |
| 1396149373 | Tlc of Georgia LLC | Nurse Practitioner | 6001 Cumming Hwy Ste 1, Sugar Hill, GA 30518-6113 | 2014-10-20 |
| 1376095638 | Tlc of Georgia LLC | Nurse Practitioner | 564 Crosstown Dr, Peachtree City, GA 30269-2916 | 2016-11-02 |
| 1447702709 | Tlc of Georgia LLC | Nurse Practitioner | 3094 Watson Blvd, Warner Robins, GA 31093-8500 | 2016-11-02 |
| 1205385119 | Tlc of Georgia LLC | Nurse Practitioner | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2016-10-04 |
| 1114476025 | Tlc of Georgia LLC | Nurse Practitioner | 378 Marketplace Pkwy, Dawsonville, GA 30534-7266 | 2016-10-04 |
| 1225587421 | Tlc of Georgia LLC | Nurse Practitioner | 125 W Main St, Cartersville, GA 30120-3507 | 2016-09-28 |
| 1386193571 | Tlc of Georgia LLC | Physician Assistant | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2016-09-28 |
| 1477945327 | Tlc of Georgia LLC | Nurse Practitioner | 1355 S Park St, Carrollton, GA 30117-4433 | 2015-03-02 |
| 1912399866 | Tlc of Georgia LLC | Nurse Practitioner | 1227 Rockbridge Rd, Stone Mountain, GA 30087-3064 | 2015-03-02 |
| Street Address |
774 GA HIGHWAY 96 |
| City | BONAIRE |
| State | GA |
| Zip Code | 31005-3300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912232927 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 774 Ga Highway 96, Bonaire, GA 31005-3300 | 2009-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669010211 | Christine Anne Hasbrouck | Nurse Practitioner | 257 Southfiled Court, Bonaire, GA 31005 | 2019-12-13 |
| 1518478023 | Cathleen Ann Cleary | Psychiatry & Neurology | 106 Julee Emilyn Drive, Bonaire, GA 31005 | 2017-10-24 |
| 1780107060 | Laura Lenhard Frawley | Nurse Practitioner | 220 Cardiff Court, Bonaire, GA 31005 | 2017-07-19 |
| 1891156758 | Southern Bridge Counseling, LLC | Community/Behavioral Health | 3100 Moody Rd, Ste. A, Bonaire, GA 31005 | 2016-03-18 |
| 1104203926 | Georgia Chiropractic and Wellness LLC | Chiropractor | 100 Stillwater Circle, Suite C, Bonaire, GA 31005 | 2015-04-30 |
| 1891197067 | Ashlee Zackeru Chafin | Nurse Anesthetist, Certified Registered | 706 Summer Ct, Bonaire, GA 31005 | 2014-09-19 |
| 1699199018 | Michelle Marie Allen | Nurse Practitioner | 774 Ga Hwy 96, Bonaire, GA 31005 | 2014-02-05 |
| 1437597168 | Lana Alden Dellinger | Physical Therapist | 101 Stillwater Circle, Bonaire, GA 31005 | 2013-06-04 |
| 1215154810 | Joseph F Mcdaniel | Pharmacist | 785 Hwy 96, Bonaire, GA 31005 | 2007-04-18 |
| 1932229242 | Marla Winge Baltz | Pharmacist | 785 Hwy. 96, Bonaire, GA 31005 | 2007-03-30 |
| Find all providers in zip 31005 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669010211 | Christine Anne Hasbrouck | Nurse Practitioner | 257 Southfiled Court, Bonaire, GA 31005 | 2019-12-13 |
| 1235613316 | Karena Collins | Nurse Practitioner | 104 Wildwood Trl, Bonaire, GA 31005-3101 | 2018-09-24 |
| 1780107060 | Laura Lenhard Frawley | Nurse Practitioner | 220 Cardiff Court, Bonaire, GA 31005 | 2017-07-19 |
| 1699199018 | Michelle Marie Allen | Nurse Practitioner | 774 Ga Hwy 96, Bonaire, GA 31005 | 2014-02-05 |
| 1225575277 | Roneseya Bentley Williams | Nurse Practitioner | 106 Moran Dr, Bonaire, GA 31005-5106 | 2017-01-30 |
| 1386674612 | Dona Michelle Tuten II | Nurse Practitioner | 106 Moran Dr, Bonaire, GA 31005-5106 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285486 | Aprn Mobile Clinic LLC | Nurse Practitioner | 1361 Highwoods Pass, Grovetown, GA 30813-3994 | 2020-11-08 |
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1104427061 | Tya Wright | Nurse Practitioner | 1450 Newnan Crossing Blvd E Apt 13205, Newnan, GA 30265-0027 | 2020-11-05 |
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1033710298 | Karen F Frazier | Nurse Practitioner | 6610 Crest Wood Ln, Douglasville, GA 30135-9046 | 2020-11-04 |
| 1619578986 | Marjorie Sewannyana | Nurse Practitioner | 553 Camano Way, Mcdonough, GA 30253-8377 | 2020-11-03 |
| 1639770027 | Markesha Leshea Groomes | Nurse Practitioner | 209 N. Cuthbert, Colquitt, GA 39837-3515 | 2020-11-03 |
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| Find all providers with the same taxonomy | ||||
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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.