WALKER LAKE INTENSIVIST, PC (NPI# 1386116309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386116309 |
| Entity Type | Organization |
| Organization Name | WALKER LAKE INTENSIVIST, PC |
| Practice Address |
1412 Milstead Ave Ne Conyers GA 30012-3877 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 7709183000 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |
| Authorized Official Name | DR. DAVID S SCHILLINGER (PRESIDENT) |
| Authorized Official Telephone | 8008939698 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1412 MILSTEAD AVE NE |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033191093 | Clifford N Grossman | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2005-11-16 |
| 1417570102 | Jonathan Stott | Registered Nurse | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2020-05-28 |
| 1104486711 | Tracie Theresa Edwards | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2019-06-17 |
| 1437629342 | Walker Lake Emergency Group, PC | Physician Assistant | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-12-04 |
| 1003385964 | Walker Lake Physician Services, PC | Internal Medicine | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-11-20 |
| 1104328095 | Enas Basha | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-03-06 |
| 1306355680 | Piedmont Rockdale Hospital Inc. | General Acute Care Hospital | 1412 Milstead Ave Ne, Conyers, GA 30012 | 2017-09-29 |
| 1093254658 | Taylor Zahn Yengst | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2017-02-15 |
| 1285186452 | Shadae Mcmillan | Podiatrist | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-11-03 |
| 1528414943 | Kimberly Anderson | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003385964 | Walker Lake Physician Services, PC | Internal Medicine | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255812731 | Pierre David Villain | Internal Medicine | 9192 Dover St, Lithia Springs, GA 30122-3813 | 2018-08-23 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1093060303 | Jrmdinc | Internal Medicine | 4300 Southern Pines Dr, Evans, GA 30809-4287 | 2012-07-23 |
| 1275896896 | Nicholas M. Maurice | Internal Medicine | 1670 Clairmont Rd # 12c-189, Decatur, GA 30033-4004 | 2012-06-19 |
| 1457626913 | Seema S Tekwani | Internal Medicine | 49 Jesse Hill Jr Dr Se # 2c001, Division of Pulmonary and Critical Care Medicine, Atlanta, GA 30303-3049 | 2012-03-16 |
| 1033381900 | Andre Lavar Holder | Internal Medicine | 80 Jesse Hill Jr Dr Se Rm 2d012, Atlanta, GA 30303-3031 | 2008-03-31 |
| 1164607974 | David Emerson Green | Internal Medicine | 1670 Clairmont Rd, (rm 12c 193-mail Stop 151p), Atlanta Va Medical Center / Emory University, Decatur, GA 30033 | 2007-12-31 |
| 1538380464 | Ram Mohan Subramanian | Internal Medicine | 1365 Clifton Rd Ne Bldg B-1, Atlanta, GA 30322-1059 | 2007-05-01 |
| 1639259666 | Juan Carlos Armstrong | Internal Medicine | 4550 Cobb Parkway North Nw Ste 210, Acworth, GA 30101-4182 | 2006-10-16 |
| 1558374041 | John Wesley King, Jr. | Internal Medicine | 641 W Thomas St, Milledgeville, GA 31061-2337 | 2006-08-14 |
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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.