GRANT AUSTIN (NPI# 1417466749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417466749 |
| Entity Type | Individual |
| Full Name | GRANT AUSTIN |
| Credential | CPED |
| Practice Address |
5035 Florence St Oakwood GA 30566-2646 |
| Mailing Address |
14 Brooks Dr Ormond Beach FL 32176-3722 |
| Practice Telephone | 7705399474 |
| Practice Fax Number | 7705311670 |
| Mailing Telephone | 3862369672 |
| Mailing Fax Number | 3862369672 |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224L00000X | Pedorthist | CPED2311 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
5035 FLORENCE ST |
| City | OAKWOOD |
| State | GA |
| Zip Code | 30566-2646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811480676 | Travis Core | Physical Therapist | 4220 Mundy Mill Pl Ste 2b, Oakwood, GA 30566 | 2018-06-07 |
| 1174922751 | Luke Lenahan | Physician Assistant | 3931 Mundy Mill Rd., Ste B, Oakwood, GA 30566 | 2014-08-19 |
| 1144584384 | Stephanie Mccullum | Occupational Therapist | 1006 Creeekside Place, Oakwood, GA 30566 | 2012-07-03 |
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1265673305 | Patti P Shipp | Counselor | 4347 Mundy Mill Rd Ste A2, Oakwood, GA 30566 | 2009-03-19 |
| 1124281217 | Ionut Radu | Optometrist | 3839 Mundy Mills Road, Oakwood, GA 30566 | 2008-07-08 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1851423057 | Oakwood Medical Clinic | Clinic/Center | 3626 Old Oakwood Rd, Oakwood, GA 30566 | 2007-03-12 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1003464538 | Nichole Abernathy Hasan | Pharmacist | Walmart Pharmacy, 3827 Mundy Mill Rd, Oakwood, GA 30566 | 2019-08-28 |
| Find all providers in zip 30566 | ||||
| Taxonomy Code | 224L00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Pedorthist |
| An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices. |
| Notes: Source: National Uniform Claim Committee [7/1/2010: new] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215580253 | Alznner 113 Walking Center Inc | Pedorthist | 2550 Pleasant Hill Rd Ste 106, Duluth, GA 30096-4153 | 2019-07-18 |
| 1174998561 | Courtney Griggers | Pedorthist | 1600 Forsyth St, Macon, GA 31201-1408 | 2015-12-10 |
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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.