DARRELL CHAD EDENFIELD (NPI# 1336412444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336412444 |
| Entity Type | Individual |
| Full Name | DARRELL CHAD EDENFIELD |
| Credential | CSTFA |
| Practice Address |
11909 Mcauley Dr Ste 100a2 Savannah GA 31419-1793 |
| Practice Telephone | 9129253767 |
| Practice Fax Number | 9129253659 |
| Mailing Telephone | 9129253767 |
| Mailing Fax Number | 9129253659 |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
NB0030960 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11909 MCAULEY DR STE 100A2 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609166255 | Taurek Erik-soussi | Physician Assistant | 505 Mall Blvd Apt 415, Savannah, GA 31406-4857 | 2011-04-17 |
| 1396062055 | Joanna Ward Dobbeck | Physician Assistant | 6602 Abercorn St Ste 102, Savannah, GA 31405 | 2010-04-21 |
| 1023017712 | Adrienne Marie Lynch | Physician Assistant | 7001 Hodgson Memorial Dr, Suite 1, Savannah, GA 31406-2549 | 2005-07-15 |
| 1366007841 | Gage Matthew Henry | Physician Assistant | 4 E Jackson Blvd, Savannah, GA 31405-5895 | 2019-05-09 |
| 1649789132 | E & M Associates LLC | Physician Assistant | 5205 Frederick St Ste A, Savannah, GA 31405-4520 | 2017-09-27 |
| 1720516834 | Gina Soule | Physician Assistant | 210 E Derenne Ave, Savannah, GA 31405-6736 | 2017-06-02 |
| 1487000519 | Angel Everidge | Physician Assistant | 11700 Mercy Blvd, Plaza D, #6, Savannah, GA 31419 | 2016-05-07 |
| 1447605969 | Vanessa Holmes | Physician Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2016-05-03 |
| 1093128621 | Jessica Wegmann | Physician Assistant | 5205 Frederick St Ste A, Savannah, GA 31405-4520 | 2014-06-11 |
| 1225397573 | Sarah Jordan Mcilwain | Physician Assistant | 4425 Paulsen St, Savannah, GA 31405-3662 | 2012-05-07 |
| Find all providers in SAVANNAH | ||||
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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.