MR. JAY HANSON WRUCK (NPI# 1437465614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437465614 |
Entity Type | Individual |
Full Name | MR. JAY HANSON WRUCK |
Credential | C.O.M.A./C.P.P. |
Practice Address |
4318 Edgewater Dr Nw Kennesaw GA 30144-5170 |
Practice Telephone | 7705921580 |
Mailing Telephone | 7705921580 |
Enumeration Date | 2010-08-25 |
Last Update Date | 2010-08-25 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | 2010#65900 | GA | Eye and Vision Services Providers |
Street Address |
4318 EDGEWATER DR NW |
City | KENNESAW |
State | GA |
Zip Code | 30144-5170 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
Find all providers in zip 30144 |
Taxonomy Code | 156F00000X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
A broad category grouping different kinds of technologists and technicians. See individual definitions. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346849809 | Jalyn Calloway | Technician/Technologist | 3655 Howell Ferry Rd Ste 400, Duluth, GA 30096-3186 | 2020-10-25 |
1003423153 | Rochelle Wyche | Technician/Technologist | 4920 Roswell Rd Ste 1, Atlanta, GA 30342-2684 | 2020-09-23 |
1952925869 | Carolyn White | Technician/Technologist | 2147 Silver Thorn Ct, Lithonia, GA 30058-3585 | 2020-06-05 |
1760004584 | Kevin John Weiner | Technician/Technologist | 3301 Buckeye Rd Ste 700, Atlanta, GA 30341-4236 | 2020-05-14 |
1568082535 | Shemeka Brownlee | Technician/Technologist | 2773 Spirit Creek Rd, Hephzibah, GA 30815-5985 | 2020-04-20 |
1558864710 | Michelle Osborne | Technician/Technologist | 1520 E Water St, Bainbridge, GA 39817-4262 | 2018-03-14 |
1376059865 | Lachaun Serena Harper | Technician/Technologist | 5825 Glenridge Dr Ste 101, Atlanta, GA 30328-5387 | 2017-12-19 |
1538678255 | Natalie Mckay | Technician/Technologist | 3915 Cascade Rd, 220, Atlanta, GA 30331 | 2017-09-26 |
1801052311 | Kwan Ha Lee | Technician/Technologist | 2442 Pleasant Hill Road, Suite 4, Duluth, GA 30096-1700 | 2008-08-04 |
1326677600 | Chari Lakey | Technician/Technologist | 1405 Clifton Rd Ne, Atlanta, GA 30322-3050 | 2020-04-07 |
Find all providers with the same taxonomy |
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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.