DR. SMITHA RAJAN MATHEW (NPI# 1225325384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225325384 |
| Entity Type | Individual |
| Full Name | DR. SMITHA RAJAN MATHEW |
| Credential | M.D |
| Practice Address |
1120 15th St Augusta GA 30912-3957 |
| Mailing Address |
1120 15th St Ste Bi1056 Augusta GA 30912-0004 |
| Practice Telephone | 7067218623 |
| Mailing Telephone | 7064465941 |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2018-07-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
081114 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154784718 | Smitha Mathew | Nurse Practitioner | 1605 Skyview Dr, Irving, TX 75060-4711 | 2016-03-31 |
| 1144843343 | Smitha Elizabeth Mathew | Orthopaedic Surgery | 200 University Ave E, Saint Paul, MN 55101-2507 | 2020-05-21 |
| 1538441233 | Smitha Mathew | Pharmacist | 2355 Ne 26th St, Ft Lauderdale, FL 33305-1628 | 2011-09-19 |
| Street Address |
1120 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
| 1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
| 1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
| 1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
| 1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
| 1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
| 1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
| 1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306955356 | Renuka Mehta | Pediatrics | Mcg 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| 1750351326 | Richard J Cartie | Pediatrics | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2006-01-25 |
| 1205270543 | Ashley Dodd Freeman | Pediatrics | 1120 15th St, Augusta, GA 30912-6805 | 2013-04-17 |
| 1457498750 | Jose Raul Ponte Jr. | Pediatrics | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2007-01-30 |
| 1477664928 | Curt M Steinhart | Pediatrics | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-31 |
| 1518077072 | Lyle E. Fisher Jr. | Pediatrics | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| 1194739011 | Mary L. Sheram | Pediatrics | 1120 15th St, Augusta, GA 30912-0004 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000358 | Spring Heather Ou-tim | Pediatrics | 5461 Meridian Marks Rd Ste 540, Atlanta, GA 30342-3283 | 2018-10-26 |
| 1184980567 | Meral M Patel | Pediatrics | 777 Hemlock St # 130, Macon, GA 31201-2102 | 2012-04-10 |
| 1477796951 | Geoffrey Edward Mickells | Pediatrics | 5901-b Peachtree Dunwoody Rd, Suite B-420, Atlanta, GA 30328-7156 | 2009-04-13 |
| 1629064134 | Samuel B. Edelman | Pediatrics | 710 Center Street, Columbus, GA 31901 | 2005-09-21 |
| 1225455793 | Lisa Lima | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1020 | 2014-03-23 |
| 1265775159 | Neelima Krishnapriya Marupudi | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2013-03-29 |
| 1114215431 | Asaad G Beshish | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-5000 | 2011-07-20 |
| 1316238074 | Nabihah R Mahmood | Pediatrics | 980 Johnson Fy Rd Ne Ste 620, Atlanta, GA 30342-1608 | 2011-04-28 |
| 1033437215 | Brandon W Kirkland | Pediatrics | 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 | 2010-05-12 |
| 1942525183 | Lauren M Hebert | Pediatrics | 4700 Waters Ave, Savannah, GA 31404 | 2010-03-31 |
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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.