KALUM LEIBA (NPI# 1336751494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336751494 |
Entity Type | Individual |
Full Name | KALUM LEIBA |
Credential | CAA |
Practice Address |
450 Northside Cherokee Blvd Canton GA 30115-8015 |
Mailing Address |
4708 Ardmore Ln Hoschton GA 30548-6227 |
Practice Telephone | 7702241000 |
Mailing Telephone | 4045632645 |
Enumeration Date | 2020-08-20 |
Last Update Date | 2020-08-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 367H00000X | Anesthesiologist Assistant | GA | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1000 Johnson Fy Rd Ne, Atlanta, GA 303421606 | 4048518000 |
Street Address |
450 NORTHSIDE CHEROKEE BLVD |
City | CANTON |
State | GA |
Zip Code | 30115-8015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295732600 | Paul J Hyler | Internal Medicine | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2005-06-30 |
1790390706 | Bradley Louis Mccoul | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-09-15 |
1164035747 | Candice Caroline Bramlett | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-08-25 |
1093339533 | Tara Talbott Oberman | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-06-01 |
1568085157 | Ross W Devantier | Specialist/Technologist, Other | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-05-19 |
1427679034 | Joseph Liverman | Specialist/Technologist, Other | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-05-05 |
1518595503 | Erica D Burns | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-03-27 |
1093346066 | Emily Beecher | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-01-29 |
1497393268 | Stephanie Knight Ellis | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2019-12-12 |
1326680620 | Ginika Ozor | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2019-10-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
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Taxonomy Code | 367H00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Anesthesiologist Assistant |
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669082772 | Cynthia Marie Colt | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2020-08-04 |
1386267573 | Jenna Staikoff | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2020-05-21 |
1396389755 | Mark Tatum | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2641 | 2019-10-29 |
1902465883 | Samantha L Prochaska | Anesthesiologist Assistant | 4665 Douglas Cir Nw Ste 100, Canton, OH 44718-3673 | 2019-06-13 |
1588141261 | Olesya Rabosyuk | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2018-07-25 |
1972936730 | Claire E. Stansbury | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2013-08-15 |
1922368208 | Carol Lynn Stith | Anesthesiologist Assistant | 4665 Douglas Cir Nw Ste 100, Canton, OH 44718-3673 | 2012-05-21 |
1598048159 | Benjamin W. Falkenberg | Anesthesiologist Assistant | 4665 Douglas Cir Nw, Suite 100, Canton, OH 44718-3673 | 2011-09-21 |
1528394285 | Colleen R Robson | Anesthesiologist Assistant | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2009-10-30 |
1386873826 | Jonathan S Eberlein | Anesthesiologist Assistant | 4665 Douglas Cir Nw Ste 100, Canton, OH 44718-3673 | 2009-07-06 |
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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.