EBOT B MANGA (NPI# 1164920716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164920716 |
| Entity Type | Individual |
| Full Name | EBOT B MANGA |
| Other Name | MR. EBOT B. MANGA |
| Practice Address |
250 North Ave Athens GA 30601-2244 |
| Practice Telephone | 7063896767 |
| Mailing Telephone | 7063896767 |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-01-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
147685 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 250 North Ave, Athens, GA 306012244 | 7063896767 |
| Street Address |
250 NORTH AVE |
| City | ATHENS |
| State | GA |
| Zip Code | 30601-2244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942270558 | Advantage Behavioral Health Systems | Clinic/Center | 250 North Ave, Athens, GA 30601-2244 | 2006-01-25 |
| 1396367181 | Tracie Rene Tomas | Counselor | 250 North Ave, Athens, GA 30601-2244 | 2020-05-14 |
| 1043832298 | Kathryn Taylor Ashmore | Social Worker | 250 North Ave, Athens, GA 30601-2244 | 2020-05-11 |
| 1093335853 | Obianuju Okpala | Nurse Practitioner | 250 North Ave, Athens, GA 30601-2244 | 2020-04-22 |
| 1427694116 | Diane M Hodge | Counselor | 250 North Ave, Athens, GA 30601-2244 | 2019-11-18 |
| 1265092191 | Margaret Molony | Behavioral Analyst | 250 North Ave, Athens, GA 30601-2244 | 2019-06-13 |
| 1407414394 | Brier Wagoner-mccann | Social Worker | 250 North Ave, Athens, GA 30601-2244 | 2019-06-05 |
| 1225596802 | Erin Ray | Social Worker | 250 North Ave, Athens, GA 30601-2244 | 2019-03-04 |
| 1720583529 | Jessica Wiggs | Counselor | 250 North Ave, Athens, GA 30601 | 2018-03-26 |
| 1568978328 | Jay D O'shields | Social Worker | 250 North Ave, Athens, GA 30601 | 2017-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154971679 | Classic City Counseling & Consultation LLC | Psychologist | 159 Oneta St., Unit 1a Suite 7, Athens, GA 30601 | 2019-09-17 |
| 1982172433 | Smith Dental Care of Athens Inc. | Clinic/Center | 801 Us Highway 29 North, Athens, GA 30601 | 2018-11-02 |
| 1356865935 | Elizabeth Anne Price | Pharmacist | 9249 Hwy 29, Athens Community Based Outpatient Va Clinic, Athens, GA 30601 | 2017-07-26 |
| 1386011575 | Janna Barham Cleveland | Nurse Practitioner | 496 Reese Street, Athens, GA 30601 | 2015-08-24 |
| 1295113769 | Brent Dillin Temple | Case Manager/Care Coordinator | 9249 Highway 29 North, Athens, GA 30601 | 2015-05-15 |
| 1356736417 | Brett Magner | Family Medicine | 855 W Broad St Ste 1, Athens, GA 30601 | 2015-04-05 |
| 1619397478 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 700 Highway 29 N, Athens, GA 30601 | 2014-04-21 |
| 1972921021 | Issa Papiss Bagayogo | Psychiatry & Neurology | 297 Prince Avenue Suite 28a, Athens, GA 30601 | 2014-04-04 |
| 1447682083 | Brittany Lynn Lowery | Counselor | 250 Bray Street, Athens, GA 30601 | 2013-08-06 |
| 1417194135 | Carey Kirk | Counselor | 295 Mles St, Athens, GA 30601 | 2009-01-16 |
| Find all providers in zip 30601 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333409 | Olivia Palmer | Nurse Practitioner | 770 W Market St, Athens, AL 35611 | 2020-10-12 |
| 1831706449 | Melissa Mason | Nurse Practitioner | 700 Oglethorpe Ave # C7, Athens, GA 30606-2221 | 2020-09-28 |
| 1972117992 | Kei Martin | Nurse Practitioner | 25569 Evergreen Ln, Athens, AL 35613-6162 | 2020-09-08 |
| 1699315192 | Paul Stewart | Nurse Practitioner | 906 Rolling Dr, Athens, TX 75751-2944 | 2020-01-13 |
| 1679118616 | Erica Lyn Prater | Nurse Practitioner | 445 Providence Rd, Athens, GA 30606-1933 | 2019-11-13 |
| 1932758828 | Paula White | Nurse Practitioner | 12 Walcon Ln Apt 2, Athens, TN 37303-3764 | 2019-09-04 |
| 1114574621 | April Lee White | Nurse Practitioner | 3655 Whiteoak Creek Rd, Athens, WV 24712-9628 | 2019-08-20 |
| 1255988937 | Brandi Jones | Nurse Practitioner | 115 Medical Cir Ste 100, Athens, TX 75751-9004 | 2019-08-19 |
| 1467008128 | Erica Denise Long | Nurse Practitioner | 220 S Jackson St, Athens, TN 37303-4713 | 2019-08-16 |
| 1215598131 | Patricia Ann Torres | Nurse Practitioner | 494 Baxter St, Athens, GA 30605-1172 | 2019-06-21 |
| Find all providers in ATHENS | ||||
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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.