MR. DANIEL WILSON KREVDO (NPI# 1427255769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427255769 |
| Entity Type | Individual |
| Full Name | MR. DANIEL WILSON KREVDO |
| Credential | RPA |
| Practice Address |
901 Griffin Ave Eastman GA 31023-6720 |
| Mailing Address |
621 North Avenue, Ne Suite C-30 Atlanta GA 30308 |
| Practice Telephone | 4784484048 |
| Practice Fax Number | 4783749797 |
| Mailing Telephone | 6789046820 |
| Mailing Fax Number | 6789046824 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
JX39313 | FL | Technologists, Technicians & Other Technical Service Providers |
| X | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
JX39313 | FL | Technologists, Technicians & Other Technical Service Providers |
| X | 2471V0106X |
Radiologic Technologist Specialization: Vascular-Interventional Technology |
JX39313 | FL | Technologists, Technicians & Other Technical Service Providers |
| X | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
901 GRIFFIN AVE |
| City | EASTMAN |
| State | GA |
| Zip Code | 31023-6720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740272095 | Dodge County Hospital Authority | Medicare Defined Swing Bed Unit | 901 Griffin Ave, Eastman, GA 31023-6720 | 2005-08-22 |
| 1356982938 | Dodge County Hospital Authority | Pharmacy | 901 Griffin Ave, Eastman, GA 31023-6720 | 2019-10-04 |
| 1346894334 | Southland Dodge Hospitalist Services LLC | Hospitalist | 901 Griffin Ave, Eastman, GA 31023-6784 | 2019-07-29 |
| 1851958607 | Southland Dodge Emergency Medical Services, LLC | Emergency Medicine | 901 Griffin Ave, Eastman, GA 31023-6720 | 2019-05-28 |
| 1881010239 | Dodge County Hospital Authority | Psychiatric Unit | 901 Griffin Ave, Eastman, GA 31023-6720 | 2014-03-10 |
| 1265853469 | Southeastern Hospitalist Physicians, LLP | Hospitalist | 901 Griffin Ave, Eastman, GA 31023-6720 | 2013-12-16 |
| 1689095812 | Southern Emergency Physicians, LLP | Hospitalist | 901 Griffin Ave, Eastman, GA 31023-6720 | 2013-12-13 |
| 1902193295 | Sweet Georgia Emergency Physicians | Emergency Medicine | 901 Griffin Ave, Eastman, GA 31023-6720 | 2011-07-07 |
| 1083901300 | Historic South Inpatient Services | Hospitalist | 901 Griffin Ave, Eastman, GA 31023-6720 | 2011-07-07 |
| 1144525940 | Keri Ann Paulk | Nurse Anesthetist, Certified Registered | 901 Griffin Ave, Eastman, GA 31023-6720 | 2011-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821555913 | Community Service Board of Middle Georgia | Day Training, Developmentally Disabled Services | 1444 Morgan Creek Dr, Eastman, GA 31023 | 2019-02-25 |
| 1174832232 | Lynetta Davies | Counselor | 17 Tanner Dr, Eastmon, GA 31023 | 2010-10-06 |
| 1467774380 | Dustin Phillip Smith | Chiropractor | 285 Plaza Avenue, Eastman, GA 31023 | 2010-02-19 |
| 1639311145 | D&b Home Care Inc | Durable Medical Equipment & Medical Supplies | 714 Medical Center Drive, Eastman, GA 31023 | 2009-03-30 |
| 1427273465 | Hospice Care Options Inc | Hospice Care, Community Based | 715 Legion Dr, Eastman, GA 31023 | 2007-04-16 |
| 1740318625 | Dana W Mullis | Dentist | 1003 Plaza Ave, Eastman, GA 31023 | 2007-03-01 |
| 1285787630 | 801 Legion LLC | Skilled Nursing Facility | 815 Legion Dr, Eastman, GA 31023 | 2007-01-19 |
| 1396813317 | Womens Health PC | Obstetrics & Gynecology | 821 Plaza Ave, Suite B, Eastman, GA 31023 | 2006-11-30 |
| 1932294170 | John D Roberts | Ophthalmology | 917 Plaza Avenue, Eastman, GA 31023 | 2006-10-04 |
| 1215030978 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 535 Oak St, Eastman, GA 31023 | 2006-09-07 |
| Find all providers in zip 31023 | ||||
| Taxonomy Code | 2471C3401X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Computed Tomography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801297189 | Lisa Gardisser | Radiologic Technologist | 2646 Hwy 56 E, Lyons, GA 30436-4358 | 2014-09-05 |
| 1457609810 | Charles M Smith | Radiologic Technologist | 113 Fairview Park Dr, Suite A, Dublin, GA 31021-2501 | 2012-08-16 |
| 1942521067 | Kevin L Marler | Radiologic Technologist | 21 Golden Ct, Sharpsburg, GA 30277-2367 | 2010-06-14 |
| 1659510808 | Donn Alan Coe | Radiologic Technologist | 3815 Lovers Ln, Monroe, GA 30656-8556 | 2009-02-11 |
| 1922281104 | Clarissa Dawn George | Radiologic Technologist | 5810 Waterfall Way, Buford, GA 30518-1376 | 2007-12-11 |
| 1619373990 | Audrey Sims | Radiologic Technologist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2014-11-13 |
| 1023362258 | Hilda Faye Bryant | Radiologic Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2012-11-09 |
| 1063711380 | Amanda Lauren Maldonado | Radiologic Technologist | 230 Duncan Dr Bldg 1440, Department of Radiology, Savannah, GA 31409-5107 | 2011-03-25 |
| 1215133038 | Jon Andrew Logan | Radiologic Technologist | 621 North Ave, Ste. C-30, Atlanta, GA 30354-1430 | 2007-06-27 |
| 1447302344 | Riverdale Radiology Center | Radiologic Technologist | 833 Walnut St, Macon, GA 31201-2617 | 2007-01-18 |
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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.