JACQUELINE NICOLE FLANDRY (NPI# 1306089800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306089800 |
| Entity Type | Individual |
| Full Name | JACQUELINE NICOLE FLANDRY |
| Other Name | JACQUELINE NICOLE FLANDRY FUSSELL |
| Credential | M.D. |
| Practice Address |
1150 Brookstone Centre Pkwy Columbus GA 31904-4577 |
| Mailing Address |
835 Cogburn Ave Nw Ste 250 Marietta GA 30060-1056 |
| Practice Telephone | 7062574189 |
| Practice Fax Number | 7062574194 |
| Mailing Telephone | 7704228815 |
| Mailing Fax Number | 7704228816 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2020-06-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 70111 | GA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 070111 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003159653A | 05 | |
| GA | MEDICARE PTAN | 202G708679 | 01 |
| Street Address |
1150 BROOKSTONE CENTRE PKWY |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-4577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487856092 | Kimberly Miller Parker | Physician Assistant | 1150 Brookstone Centre Pkwy, Columbus, GA 31904-4577 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174972434 | West Georgia Medical Associates | Dermatology | 6600 Whittlesey Blvd Bldg A, Columbus, GA 31909-7251 | 2016-06-08 |
| 1770958092 | Diagnostic Dermatopathology | Dermatology | 2101 Brookstone Centre Pkwy, Ste 300, Columbus, GA 31904-9254 | 2015-12-11 |
| 1912379421 | Danielle Wiseley | Dermatology | 1150 Brookstone Centre Parkway, Columbus, GA 31904-4577 | 2015-10-22 |
| 1538503255 | Natalie Grace Spaccarelli | Dermatology | 1328 Dublin Rd Ste 100, Columbus, OH 43215-1054 | 2013-04-24 |
| 1669745279 | James Francis Hamilton | Dermatology | 1710 Essex Rd, Columbus, OH 43221 | 2012-02-13 |
| 1588977912 | Jessica Amie Kaffenberger | Dermatology | 540 Office Center Pl, Suite 240, Columbus, OH 43230-5317 | 2010-07-14 |
| 1821329616 | Comprehensive Skin Cancer Center | Dermatology | 1339 La Rochelle Dr, Columbus, OH 43221-1531 | 2010-01-19 |
| 1982836037 | Bethany R Hairston Md | Dermatology | 724 Leigh Drive, Columbus, MS 39705-3098 | 2009-08-21 |
| 1205011574 | Sandra Jones Wu Md Inc | Dermatology | 1194 Old Henderson Rd Ste A, Columbus, OH 43220-3694 | 2008-01-07 |
| 1477767846 | Monique Elise Kademian | Dermatology | 2100 Marble Cliff Office Park, Columbus, OH 43215-1056 | 2007-05-09 |
| Find all providers in COLUMBUS | ||||
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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.