DIGESTIVE HEALTHCARE OF GA, P.C. (NPI# 1477978799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477978799 |
| Entity Type | Organization |
| Organization Name | DIGESTIVE HEALTHCARE OF GA, P.C. |
| Other Organization Name | DIGESTIVE HEALTHCARE OF GA CANTON |
| Practice Address |
104 Prominence Point Pkwy Suite 104 Canton GA 30114-1236 |
| Mailing Address |
95 Collier Rd Nw Suite 4075 Atlanta GA 30309-1796 |
| Practice Telephone | 7707046988 |
| Practice Fax Number | 7707208775 |
| Mailing Telephone | 4046033543 |
| Mailing Fax Number | 7703508795 |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-02-24 |
| Authorized Official Name | MISS SHELLY MONIQUE ROBINSON (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 4046033543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Digestive Healthcare of GA Canton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225452931 | Digestive Healthcare of Ga, P.C. | Specialist | 95 Collier Road, Suite 4075, Atlanta, GA 30309-1751 | 2014-02-17 |
| 1053735761 | Digestive Healthcare of Ga, P.C. | Specialist | 97 Hefner St, Suite 203, East Ellijay, GA 30540-8268 | 2014-02-17 |
| Street Address |
104 PROMINENCE POINT PKWY SUITE 104 |
| City | CANTON |
| State | GA |
| Zip Code | 30114-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659467629 | Jeffrey Haller | Family Medicine | 104 Prominence Point Pkwy, Ste 104, Canton, GA 30114-1236 | 2006-10-05 |
| 1043657521 | Ambreen Mardhani | Family Medicine | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2013-05-24 |
| 1013253103 | Amy Marie Wheeler | Nurse Practitioner | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2012-12-18 |
| 1912123761 | Kathryn G Brady | Physician Assistant | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2007-04-18 |
| 1083778989 | Brenda Gail Fritz | Dentist | 104 Prominence Point Pkwy, Suite 102, Canton, GA 30114-1236 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 |
|---|---|---|---|---|
| 1639223308 | Sanjiv Khetarpal | Internal Medicine | 4665 Belpar St Nw, Canton, OH 44718 | 2007-01-22 |
| 1326064254 | Edward Thomas Schirack | Internal Medicine | 3722 Dressler Road Nw, Canton, OH 44718 | 2006-07-14 |
| 1326027376 | Khalil B Korkor | Internal Medicine | 4124 Munson St Nw, Suite A, Canton, OH 44718-2979 | 2006-01-10 |
| 1821070830 | Karim Gani | Internal Medicine | 145 Riverstone Ter, Suite 100, Canton, GA 30114-5317 | 2005-11-16 |
| 1013917624 | Sebastian Angelo Mazzotta | Internal Medicine | 4 Stillman Dr, Canton, NY 13617-1221 | 2005-07-26 |
| 1093710055 | Kenny S Yung | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2005-06-16 |
| 1497750822 | Nabil Fahmy | Internal Medicine | 4360 Fulton Dr Nw, Ste B, Canton, OH 44718-2824 | 2005-06-14 |
| 1245740661 | Ellen Lintner | Internal Medicine | 3722 Dressler Rd Nw, Canton, OH 44718-2700 | 2017-10-11 |
| 1639617608 | Gsi Canton LLC | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2017-02-09 |
| 1972891737 | Amareshwar Podugu | Internal Medicine | 2726 Fulton Dr Nw, Canton, OH 44718-3506 | 2011-07-14 |
| Find all providers in CANTON | ||||
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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.