DR. KENNETH F. MENCHION (NPI# 1508822776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508822776 |
| Entity Type | Individual |
| Full Name | DR. KENNETH F. MENCHION |
| Credential | MD |
| Practice Address |
350 Country Club Dr Suite A Stockbridge GA 30281-9084 |
| Practice Telephone | 7706924000 |
| Practice Fax Number | 7704748510 |
| Mailing Telephone | 7706924000 |
| Mailing Fax Number | 7704748510 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2020-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
047236 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000821378D | 05 |
| Street Address |
350 COUNTRY CLUB DR SUITE A |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-9084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124023304 | Gregory Paul Petro | Internal Medicine | 350 Country Club Dr, Suite A, Stockbridge, GA 30281-9084 | 2005-06-15 |
| 1568927515 | Trevor Breck Armstrong | Nurse Practitioner | 350 Country Club Dr, Stockbridge, GA 30281-9084 | 2019-02-04 |
| 1487162392 | Rachel Gatlin Estes | Nurse Practitioner | 350 Country Club Dr, Stockbridge, GA 30281-9084 | 2018-01-12 |
| 1588199657 | Amanda Lauren Farrell | Nurse Practitioner | 350 Country Club Dr, Stockbridge, GA 30281-9084 | 2017-04-26 |
| 1104086982 | Annie Josephine Cruz | Obstetrics & Gynecology | 350 Country Club Dr, Suite D, Stockbridge, GA 30281-9084 | 2008-06-14 |
| 1265624167 | Michael R Rutledge | Internal Medicine | 350 Country Club Dr, Suite A, Stockbridge, GA 30281-9084 | 2007-08-14 |
| 1013126341 | Jarrod D Day | Surgery | 350 Country Club Dr, Suite A, Stockbridge, GA 30281-9084 | 2007-05-22 |
| 1679695266 | Gary A Bartholomew | Dentist | 350 Country Club Dr, Suite E, Stockbridge, GA 30281-9084 | 2007-04-04 |
| 1710011333 | Jauna D Royal | Nurse Practitioner | 350 Country Club Dr, Suite A, Stockbridge, GA 30281-9084 | 2007-03-15 |
| 1992835698 | Eagle's Landing Ob Gyn 2 LLC | Obstetrics & Gynecology | 350 Country Club Dr, Suite D, Stockbridge, GA 30281-9084 | 2007-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598965006 | Paul Bernard Jones | Surgery | 7402 Davidson Cir W, Stockbridge, GA 30281 | 2007-07-23 |
| 1013126341 | Jarrod D Day | Surgery | 350 Country Club Dr, Suite A, Stockbridge, GA 30281-9084 | 2007-05-22 |
| 1558414276 | Alan Merrill Levy | Surgery | 1035 Southcrest Dr, Suite 250, Stockbridge, GA 30281-6118 | 2007-01-18 |
| 1174676829 | Daniel Thomas Mcdevitt | Surgery | 1035 Southcrest Dr, Suite 250, Stockbridge, GA 30281-6118 | 2007-01-18 |
| 1902864291 | Comprehensive Vascular Surgery of Georgia | Surgery | 150 Country Club Dr, Suite 100, Stockbridge, GA 30281-7344 | 2006-05-03 |
| 1639130453 | Albert Teiko Tagoe | Surgery | 150 Country Club Dr, Suite 100, Stockbridge, GA 30281-7344 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1902423387 | Center for Vein Restoration Ga Corp | Surgery | 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 | 2020-07-01 |
| 1487133278 | Usa Vascular Center of Decatur LLC | Surgery | 495 Winn Way Ste 230, Decatur, GA 30030-1736 | 2018-08-13 |
| 1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1689012205 | Daniel Joseph Badia | Surgery | 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 | 2013-06-05 |
| 1740507425 | Christopher Ray Ramos | Surgery | 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 | 2010-04-21 |
| 1184879678 | Rockdale Vascular and Thoracic Surgery, LLC | Surgery | 1368c Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2008-11-25 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1487819132 | Yazan Duwayri | Surgery | Division of Vascular Surgery Emory Clinic Bldg A, 1365 Clifton Road Ne. 3rd Floor, Atlanta, GA 30322-0001 | 2008-07-22 |
| Find all providers with the same taxonomy | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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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.