CORRECTIONA MEDICAL ASSOCIATES (NPI# 1407017965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407017965 |
| Entity Type | Organization |
| Organization Name | CORRECTIONA MEDICAL ASSOCIATES |
| Practice Address |
205 Mcintosh Place Dr Fayetteville GA 30214-7384 |
| Practice Telephone | 7707193319 |
| Mailing Telephone | 7707193319 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | DR. MARCUS MOSELEY (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4048532097 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | RN113001 | GA | Ambulatory Health Care Facilities |
| Street Address |
205 MCINTOSH PLACE DR |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7384 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683032 | Red Earth Acupuncture | Clinic/Center | 1836 Highway 54 W, Fayetteville, GA 30214-4742 | 2019-05-06 |
| 1477033728 | Swetnam Cosmetic Surgery, Pllc | Clinic/Center | 1695 E Rainforest Rd Ste 3, Fayetteville, AR 72703-5385 | 2018-08-16 |
| 1023500725 | Greenbrook Tms Fayetteville LLC | Clinic/Center | 1991 Fordham Dr Ste 202, Fayetteville, NC 28304-3774 | 2018-05-30 |
| 1871013367 | Shiloh Health and Longevity | Clinic/Center | 1794 E Joyce Blvd Ste 1, Fayetteville, AR 72703-5257 | 2017-06-26 |
| 1942687900 | St Marys Hca of South Carolina | Clinic/Center | 2603 Cumberland Gap Drive, Suite 203, Fayetteville, NC 28306 | 2015-04-29 |
| 1376728154 | Massage Therapeutics, Inc Center for Wellness | Clinic/Center | 500 Lanier Ave W Ste 411, Fayetteville, GA 30214-7638 | 2007-12-30 |
| 1578767299 | Kidzplex Fitness | Clinic/Center | 1830q Owen Dr, Fayetteville, NC 28304-3421 | 2007-06-14 |
| 1114067519 | Rediclinic LLC | Clinic/Center | 3911 North Mall Avenue, Fayetteville, AR 72703 | 2007-02-07 |
| 1932202447 | Appalachian Regional Healthcare | Clinic/Center | 436 Elizabeth Way, Fayetteville, WV 25840 | 2006-09-07 |
| 1992320089 | One Stick Medical Academy | Clinic/Center | 101 Beckett Ln Ste 505, Fayetteville, GA 30214-7160 | 2020-06-15 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on CORRECTIONA MEDICAL ASSOCIATES.
| 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.