RUSSELL FARR SHEARER JR. (NPI# 1265700918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265700918 |
| Entity Type | Individual |
| Full Name | RUSSELL FARR SHEARER JR. |
| Credential | PH.D. |
| Practice Address |
2400 Mt. Zion Parkway Kaiser Permanente Southwood Medical Center Jonesboro GA 30236 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7706033632 |
| Mailing Telephone | 4043647070 |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2012-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PSY003453 | GA | Behavioral Health & Social Service Providers |
| Street Address |
2400 MT. ZION PARKWAY KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508866153 | Jodi Bayley Baptiste | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2005-07-26 |
| 1013450816 | Dorothy Delisfort-crisostomo | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehension Medical Offic, Jonesboro, GA 30236 | 2016-11-28 |
| 1639590136 | Ashley Christine Ziobrowski | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-12-31 |
| 1730520321 | Nash Ditmetaroj | Optometrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2013-07-10 |
| 1770927402 | Labrittany R Davis-farve | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-24 |
| 1477896645 | Fofie S Akoto | Internal Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-04-05 |
| 1265773584 | Karen Kelly Willard | Nurse Practitioner | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-03-12 |
| 1114264652 | Jaclyn Marie Schwartz | Podiatrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-01-03 |
| 1801144605 | Dorie Angela Saxon | Pediatrics | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-08-28 |
| 1689937880 | Meena Yasmeen | Family Medicine | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2012-06-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407936560 | Hope Mcclintock Gilchrist | Psychologist | 522 W Washington Ave, Jonesboro, AR 72401-2780 | 2006-10-16 |
| 1396841565 | George M De Roeck | Psychologist | 308 W Monroe Ave, Jonesboro, AR 72401-2741 | 2006-09-15 |
| 1346343597 | James Paul Moore | Psychologist | 260 Southwest Drive, Jonesboro, AR 72401 | 2006-09-06 |
| 1407888662 | Suzanne Gibbard | Psychologist | 522 West Washington Ave, Jonesboro, AR 72401 | 2006-07-07 |
| 1033721113 | Hannah Yael Paull | Psychologist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2020-08-19 |
| 1497025845 | Abby M Myers | Psychologist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Medical Center, Jonesboro, GA 30236 | 2012-01-03 |
| 1356659098 | Stephen Paul Pipkin | Psychologist | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2010-09-15 |
| 1609046259 | Anita Gail Wells | Psychologist | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2008-03-10 |
| 1992841654 | Lesli Annette-elkins Baltz | Psychologist | 1815 Pleasant Grove Rd, Jonesboro, AR 72401-7870 | 2007-01-29 |
| 1316098643 | Margaret B Rector | Psychologist | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-01-15 |
| Find all providers in JONESBORO | ||||
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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.