DR. DAVID WAYNE LARISCY (NPI# 1134362718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134362718 |
| Entity Type | Individual |
| Full Name | DR. DAVID WAYNE LARISCY |
| Credential | MD |
| Practice Address |
5 Grady Johnson Rd Statesboro GA 30458-6026 |
| Practice Telephone | 9124896246 |
| Practice Fax Number | 9124896346 |
| Mailing Telephone | 9124896246 |
| Mailing Fax Number | 9124896346 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2018-11-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
074285 | GA | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
074285 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 Cedar St Ste 107, Metter, GA 304393338 | 9124896246 | 9124896346 |
| Street Address |
5 GRADY JOHNSON RD |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-6026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174590863 | David R Nabert | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-03-02 |
| 1063062511 | Stephanie E Pinard | Nurse Practitioner | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2019-09-17 |
| 1053562538 | Jenny R Janney | Physician Assistant | 5 Grady Johnson Rd, Statesboro, GA 30458 | 2008-10-02 |
| 1295997302 | Julio Estuardo Schwarz | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2008-06-30 |
| 1841388782 | Abraham K Lin | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-10-10 |
| 1205840105 | Statesboro Cardiology, PC | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-07-28 |
| 1801835194 | Stanley J Shin | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982940987 | Southeastern Cardiovascular Associates LLC | Internal Medicine | 1076 Bermuda Run, Statesboro, GA 30458-0858 | 2012-12-19 |
| 1174590863 | David R Nabert | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-03-02 |
| 1013908086 | Anthony B. Chappell | Internal Medicine | 1076 Bermuda Run Road, Statesboro, GA 30458-0858 | 2005-10-31 |
| 1841388782 | Abraham K Lin | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-10-10 |
| 1205840105 | Statesboro Cardiology, PC | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-07-28 |
| 1104853787 | Ajay Jain | Internal Medicine | 1497 Fair Rd, Suite 305, Statesboro, GA 30458-0822 | 2006-06-27 |
| 1801835194 | Stanley J Shin | Internal Medicine | 5 Grady Johnson Rd, Statesboro, GA 30458-6026 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013571033 | Norihiko Kamioka | Internal Medicine | 1364 Clifton Rd Ne Ste D422, Atlanta, GA 30322-1059 | 2019-04-24 |
| 1992229884 | Medical Software, LLC | Internal Medicine | 3855 Pleasant Hill Rd Ste 350, Duluth, GA 30096-8093 | 2017-08-01 |
| 1215399456 | Raymond Mai | Internal Medicine | 1120 15th St # 6518, Augusta, GA 30912-1436 | 2016-03-27 |
| 1043684954 | Columbus Cardiology Associates, PC | Internal Medicine | 905 N Jackson St, Ste B, Americus, GA 31719-3089 | 2015-11-17 |
| 1649693045 | Avantgarde Consultants, Inc. | Internal Medicine | 10945 State Bridge Rd Ste 401-708, Alpharetta, GA 30022-8164 | 2014-01-22 |
| 1194153973 | Epic Group 8 | Internal Medicine | 760 Old Roswell Rd, Suite 114, Roswell, GA 30076-2279 | 2013-10-14 |
| 1265798763 | Sulay Pankaj Patel | Internal Medicine | 101 Woodruff Circle Wmb 1013, Atlanta, GA 30322 | 2012-04-09 |
| 1073879573 | Ozlem Bilen | Internal Medicine | Emory University Cardiovascular, 101 Woodruff Circle, Wmb 3004, Atlanta, GA 30322-0001 | 2012-04-09 |
| 1962779611 | Cardiac Consultants of Central Georgia | Internal Medicine | 2024 Watson Blvd Bldg 1, Warner Robins, GA 31093-3624 | 2011-11-23 |
| 1861771701 | Hyo Jin Song | Internal Medicine | 1505 Northside Blvd Ste 3600, Cumming, GA 30041-8245 | 2011-08-09 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
Please comment or provide details below to improve the information on DR. DAVID WAYNE LARISCY.
| 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.