COLISEUM HEALTH GROUP, LLC (NPI# 1134168115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134168115 |
| Entity Type | Organization |
| Organization Name | COLISEUM HEALTH GROUP, LLC |
| Other Organization Name | COLISEUM PRIMARY HEALTHCARE |
| Practice Address |
3200 Riverside Dr Macon GA 31210-2550 |
| Practice Telephone | 4787571500 |
| Mailing Telephone | 4787571500 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-10-01 |
| Authorized Official Name | MIKE MASSEY (VP) |
| Authorized Official Telephone | 4787571500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coliseum Primary Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043254360 | Coliseum Health Group, LLC | Family Medicine | 420 Charter Blvd, Suite 304, Macon, GA 31210-4854 | 2006-06-16 |
| 1912947367 | Coliseum Health Group, LLC | Pediatrics | 360 Hospital Dr, Suite 110, Macon, GA 31217-3874 | 2006-06-07 |
| Street Address |
3200 RIVERSIDE DR |
| City | MACON |
| State | GA |
| Zip Code | 31210-2550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376524363 | Darby Physical Therapy Associates | Occupational Therapy Assistant | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2005-11-08 |
| 1578999033 | Robert C Jones Md LLC | Clinic/Center | 3200 Riverside Dr, Ste B300, Macon, GA 31210-2550 | 2013-09-16 |
| 1821423112 | Ensphere Resources, LLC | Specialist | 3200 Riverside Dr, Suite B275, Macon, GA 31210-2550 | 2013-09-05 |
| 1508000332 | Jeremy Jacob Prine | Anesthesiology | 3200 Riverside Dr, Bldg C, Macon, GA 31210-2550 | 2009-04-23 |
| 1336256411 | Robert Adam Medrzycki | Physical Therapist | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2006-08-24 |
| 1518978824 | Stacy L Hamlin | Physical Therapy Assistant | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2006-08-11 |
| 1063423432 | Frederick W Sitterding | Occupational Therapist | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2006-08-11 |
| 1619988995 | Amy M Tyler | Physical Therapy Assistant | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2006-08-11 |
| 1215995659 | Sunshine Resources | Occupational Therapist | 3200 Riverside Dr, Suite 300-a, Macon, GA 31210-2550 | 2006-05-03 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393953 | Umerah Family Practice LLC | Family Medicine | 112 Arkwright Lndg Ste B, Macon, GA 31210-1364 | 2019-12-16 |
| 1992267892 | Andel Anthony Higgins | Family Medicine | 3780 Eisenhower Parkway, Macon, GA 31206 | 2019-04-01 |
| 1578025300 | Shail Patel | Family Medicine | 3780 Eisenhower Pkwy Ste 1, Macon, GA 31206-0801 | 2019-04-01 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1255779351 | Kristopher K Mcjenkin | Family Medicine | 105 Bass Plantation Dr, Apt 607, Macon, GA 31210-5735 | 2013-06-11 |
| 1750620191 | Derrick Lane, Md, LLC | Family Medicine | 818 Forsyth St, Macon, GA 31201-2139 | 2013-02-05 |
| 1215182977 | Unlimited Medical Solutions, Inc. | Family Medicine | 3200 Riverside Dr Bldg B, Macon, GA 31210-2550 | 2008-11-22 |
| 1144474784 | Jack Fernando Menendez | Family Medicine | 376 Rogers Ave, Macon, GA 31204-2506 | 2008-11-10 |
| 1255504098 | Veera Pavuluri | Family Medicine | 132 Madison North Dr, Macon, GA 31220-7626 | 2008-04-11 |
| 1871770412 | Albert Warren Jr. | Family Medicine | 1339 Gray Hwy, Macon, GA 31211-1903 | 2008-01-25 |
| Find all providers in MACON | ||||
Please comment or provide details below to improve the information on COLISEUM HEALTH GROUP, LLC.
| 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.