SOUTH GEORGIA ER SERVICES, LLC (NPI# 1548763899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548763899 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA ER SERVICES, LLC |
| Practice Address |
313 Carrick Way Macon GA 31210-4952 |
| Practice Telephone | 9126606220 |
| Practice Fax Number | 9127647522 |
| Mailing Telephone | 9126606220 |
| Mailing Fax Number | 9127647522 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | DR. GARY H DENT (PRESIDENT) |
| Authorized Official Telephone | 9126606220 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
313 CARRICK WAY |
| City | MACON |
| State | GA |
| Zip Code | 31210-4952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265935522 | South Georgia Hospitalist Services, LLC | Hospitalist | 313 Carrick Way, Macon, GA 31210-4952 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841419595 | Theodore A. Bowles Jr. | Emergency Medicine | 109 Princeton Dr, Macon, GA 31220-8739 | 2007-04-24 |
| 1942244017 | Caleb Duro Ajibade | Emergency Medicine | 176 Springfield Blvd, Macon, GA 31210-1673 | 2006-06-16 |
| 1629043575 | Harvey Norman Clarkson | Emergency Medicine | 1205 N Missouri St, Macon, MO 63552-2095 | 2006-02-22 |
| 1427047422 | Manishkumar Rajanikant Joshi | Emergency Medicine | 3400 Riverside Dr, Macon, GA 31210-2513 | 2005-10-21 |
| 1821091810 | James L Deline | Emergency Medicine | 307 Mckay St, Macon, MO 63552-2029 | 2005-05-24 |
| 1386209815 | Adelina Roxana Buganu | Emergency Medicine | 380 Hospital Dr, Macon, GA 31217-8001 | 2019-05-09 |
| 1366977647 | Mitali Mehta | Emergency Medicine | 350 Hospital Dr, Macon, GA 31217-3838 | 2017-04-25 |
| 1922456300 | K.v. Panchapakasan, M.d. PC | Emergency Medicine | 818 Forsyth St, Macon, GA 31201-2139 | 2016-05-26 |
| 1659734630 | Douglas Jason Buckert | Emergency Medicine | 350 Hospital Dr, Macon, GA 31217-3838 | 2016-03-29 |
| 1598126641 | Central Georgia Emergency Group, LLC | Emergency Medicine | 777 Hemlock St, Macon, GA 31201-2102 | 2016-03-17 |
| Find all providers in MACON | ||||
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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.