DR. IAN RUSSELL DRISCOLL (NPI# 1194854091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194854091 |
| Entity Type | Individual |
| Full Name | DR. IAN RUSSELL DRISCOLL |
| Credential | M.D. |
| Practice Address |
1416 Wainbrook Dr Augusta GA 30909-6289 |
| Mailing Address |
Po Box 3548 Augusta GA 30914-3548 |
| Practice Telephone | 7068639595 |
| Practice Fax Number | 7068688375 |
| Mailing Telephone | 7068639595 |
| Mailing Fax Number | 7068688375 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
77728 | GA | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
0101244576 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
1416 WAINBROOK DR |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-6289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144262148 | Christopher David Anna | Podiatrist | 1416 Wainbrook Dr, Augusta, GA 30909-6289 | 2006-06-12 |
| 1467887877 | Trevor Sean Payne | Podiatrist | 1416 Wainbrook Dr, Augusta, GA 30909-6289 | 2013-09-05 |
| 1366513988 | Augusta Foot & Ankle, PC | Podiatrist | 1416 Wainbrook Dr, Augusta, GA 30909-6289 | 2006-11-13 |
| 1023114238 | Mickey Dwight Stapp | Podiatrist | 1416 Wainbrook Dr, Augusta, GA 30909-6289 | 2006-09-15 |
| 1275639692 | Brian Nathan Bennett | Podiatrist | 1416 Wainbrook Dr, Augusta, GA 30909-6289 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245456706 | Cassandra Quiana White | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2007-04-17 |
| 1083724454 | Michael L. Hawkins | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| 1053381145 | Keith F. O'malley | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205192424 | Nathan John Klingensmith | Surgery | 69 Jesse Hill Jr Drive, Se, Glenn Memorial Building, 3rd Floor, Atlanta, GA 30303 | 2012-04-03 |
| 1306928809 | Kevin J Farrell | Surgery | 101 West Ponce Deleon Ave, Emory Medical Care Foundation Ste 331, Decatur, GA 30030 | 2006-10-20 |
| 1972503837 | Gregory R Strauther | Surgery | 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 | 2005-07-21 |
| 1841583119 | Brian H Gibson | Surgery | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2011-05-19 |
| 1699065573 | Wellstar Medical Group, LLC | Surgery | 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1156 | 2011-04-13 |
| 1710283460 | Malcolm Ingram Goodchild | Surgery | 2737 Warm Springs Rd, Building A, Columbus, GA 31904-6859 | 2011-01-28 |
| 1215248604 | James G Boron | Surgery | 55 Whitcher St Ne Ste 130, Marietta, GA 30060 | 2010-06-30 |
| 1427377043 | James Clifton Haynes | Surgery | 2500 Hospital Blvd Ste 290, Roswell, GA 30076-4918 | 2010-05-21 |
| 1700047784 | Keren Aviva Bashan-gilzenrat | Surgery | 55 Whitcher St Ne Ste 130, Marietta, GA 30060 | 2008-06-22 |
| 1790946762 | Katherine Kohler | Surgery | 69 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3033 | 2008-06-22 |
| 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.