MRS. ASHLEY LACEY BOSTICK (NPI# 1306190178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306190178 |
| Entity Type | Individual |
| Full Name | MRS. ASHLEY LACEY BOSTICK |
| Credential | NP |
| Practice Address |
3131 S Main St Moultrie GA 31768-6925 |
| Mailing Address |
Po Box 40 Moultrie GA 31776-0040 |
| Practice Telephone | 2298919131 |
| Practice Fax Number | 2298919079 |
| Mailing Telephone | 2298919131 |
| Mailing Fax Number | 2298919079 |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN181134 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8 Live Oak Ct, Moultrie, GA 317686783 | 2298906612 | |
| 914 S Broad St, Thomasville, GA 317926113 | 2298903414 |
| Street Address |
3131 S MAIN ST |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-6925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255323564 | Dale Mcgregor | Emergency Medicine | 3131 S Main St, Moultrie, GA 31768-6925 | 2005-08-22 |
| 1144861485 | Rebecca Lee Hayes | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-10-07 |
| 1942865480 | Colquitt Regional Pathology, LLC | Pathology | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-05-09 |
| 1669937264 | Colquitt County Hospital Authority | Pharmacy | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-02-07 |
| 1407331143 | Christopher Neil Medders | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-09-28 |
| 1255832671 | Alexa Smith | Occupational Therapist | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-02-21 |
| 1346757481 | Jeffery W Roberts | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-01-10 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1689188906 | Mary Ann Waller | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-11-22 |
| 1063923688 | Radiology Associates of Moultrie LLC | Radiology | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-10-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1932631371 | Convenient Care, LLC | Nurse Practitioner | 207 31st Ave Se, Moultrie, GA 31768-6703 | 2017-04-03 |
| 1588072680 | Jessica Fields | Nurse Practitioner | 1 Magnolia Ct, Moultrie, GA 31768-6764 | 2014-08-01 |
| 1326483900 | Rebecca H Peters | Nurse Practitioner | 7 Hospital Park, Moultrie, GA 31768-6772 | 2013-05-08 |
| 1255488789 | Charles W Bryant | Nurse Practitioner | 1 Sweet Bay Ct, Suite B, Moultrie, GA 31768-6756 | 2007-01-05 |
| 1235292350 | Karen Strickland Carver | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2006-12-19 |
| 1881765154 | Hope Littleton | Nurse Practitioner | 9 Hospital Park, Moultrie, GA 31768-6772 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841186 | Cynthia Marie Benjamin Bates | Nurse Practitioner | 2746 Willis Foreman Rd, Hephzibah, GA 30815-6935 | 2020-11-06 |
| 1841891199 | Gloria Oduro | Nurse Practitioner | 983 Bentley Estates Dr, Dacula, GA 30019-7795 | 2020-11-03 |
| 1689274094 | Shundria Brown | Nurse Practitioner | 2122 Ellwyn Dr, Chamblee, GA 30341-1520 | 2020-10-27 |
| 1629677455 | Amy Lynn Patterson | Nurse Practitioner | 254 Senna St, Marietta, GA 30064-4417 | 2020-10-22 |
| 1538768965 | Tabitha Ford | Nurse Practitioner | 110 Shorter St Lot 9, Ty Ty, GA 31795-3179 | 2020-10-16 |
| 1902404320 | Shanelle Lynette Raiford | Nurse Practitioner | 2028 Hidden Meadow Ln, Stone Mountain, GA 30088-4448 | 2020-10-16 |
| 1760089072 | Diana Maresi Bulimu | Nurse Practitioner | 6050 Peachtree Pkwy # 240-178, Norcross, GA 30092-3336 | 2020-10-08 |
| 1760089692 | Natalie Xiomara Leak | Nurse Practitioner | 4855 Chesterfield Ct, Suwanee, GA 30024-1350 | 2020-10-05 |
| 1548877723 | Camille Watson-clarke | Nurse Practitioner | 3650 Steve Reynolds Blvd Ste 316, Duluth, GA 30096-4506 | 2020-09-30 |
| 1801403654 | Jacqueline Richart | Nurse Practitioner | 6300 Hospital Pkwy Ste 260, Johns Creek, GA 30097-1829 | 2020-09-25 |
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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.