ASHLEY SUZAM NORDSTROM (NPI# 1568636306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568636306 |
| Entity Type | Individual |
| Full Name | ASHLEY SUZAM NORDSTROM |
| Other Name | ASHLEY SUZAM RAVENEL |
| Credential | PA-C |
| Practice Address |
898 College St Suite A Monticello GA 31064-1258 |
| Practice Telephone | 7064680988 |
| Practice Fax Number | 7064686631 |
| Mailing Telephone | 7064680988 |
| Mailing Fax Number | 7064686631 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2014-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 005296 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003141276A | 05 |
| Street Address |
898 COLLEGE ST SUITE A |
| City | MONTICELLO |
| State | GA |
| Zip Code | 31064-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031750 | Jasper Health Services, Inc. | Internal Medicine | 898 College St, Monticello, GA 31064-1261 | 2005-05-30 |
| 1942563770 | Nataliya Kubasova | Family Medicine | 898 College St, Monticello, GA 31064-1258 | 2012-06-18 |
| 1972883452 | Robert A Cumbie | Pharmacist | 898 College St, Monticello, GA 31064-1258 | 2011-08-28 |
| 1356659825 | Elizabeth Copelan Wood | Physician Assistant | 898 College St, Monticello, GA 31064-1258 | 2010-09-18 |
| 1972715795 | Jasper Health Services, Inc. | Medicare Defined Swing Bed Unit | 898 College St, Monticello, GA 31064-1261 | 2007-05-04 |
| 1285729111 | Cardiac Disease Specialists, PC | Internal Medicine | 898 College St, Monticello, GA 31064-1261 | 2006-10-04 |
| 1326089475 | Kirk Tahama Brown | Emergency Medicine | 898 College St, Monticello, GA 31064-1261 | 2006-06-09 |
| 1316984552 | Gurbax Soni | Emergency Medicine | 898 College St, Monticello, GA 31064-1261 | 2006-05-31 |
| 1518956481 | Jasper Health Services Inc. | Skilled Nursing Facility | 898 College St, Monticello, GA 31064-1261 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568935757 | Neighborcare Pharmacy | Pharmacy | 3 Short St., Monticello, GA 31064 | 2019-01-10 |
| 1932563178 | Mary Catherine Sikes | Specialist/Technologist | 126 Hwy 212 West, Monticello, GA 31064 | 2016-04-13 |
| 1801018288 | Griswold Chiropractic | Chiropractor | 111 W. Washington St, Monticello, GA 31064 | 2007-05-03 |
| 1881733392 | Garrett Medical Supplies | Durable Medical Equipment & Medical Supplies | 126 Greene Street, Montilcello, GA 31064 | 2007-02-05 |
| 1629189212 | Stephen R Griswold | Chiropractor | 111 West Washington St, Monticello, GA 31064 | 2006-08-31 |
| 1144293457 | Jamie Alan Mitchell | Dentist | 458 W Washington St, Monticello, GA 31064 | 2006-02-08 |
| 1295738722 | Shannon T Barton | Family Medicine | 545 Venture Court, Monticello, GA 31064 | 2005-05-30 |
| 1093011314 | W Kenny Blake Md LLC | Family Medicine | 545 Venture Court, Monticello, GA 31064 | 2011-02-03 |
| 1811293137 | Shannon T. Barton Md LLC | Family Medicine | 545 Venture Court, Monticello, GA 31064 | 2011-02-03 |
| 1609859818 | Jasper County Emergency Medical Service | Ambulance | 185 Highway 212 W, Monticello, GA 31064-0000 | 2005-11-22 |
| Find all providers in zip 31064 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720170533 | Donald Duane Stoner | Physician Assistant | 60 Jefferson St Ste 3, Hudson River Healthcare, Inc., Monticello, NY 12701-1131 | 2006-09-29 |
| 1043251846 | Lauren A Coovert | Physician Assistant | 1000 Medical Center Drive, Monticello, IL 61856 | 2006-06-10 |
| 1124019286 | Laura Patricia Lee | Physician Assistant | 1111 N State St, Monticello, IL 61856-1151 | 2005-10-28 |
| 1871586891 | Jennifer Thornell | Physician Assistant | 38 Concord Rd, Monticello, NY 12701-3210 | 2005-08-24 |
| 1487646337 | Blen Arlow Freestone | Physician Assistant | 364 W 100 N, Monticello, UT 84535-1054 | 2005-08-17 |
| 1013499367 | Kathryn Ann Alvarez | Physician Assistant | 1001 Hart Blvd Ste 100, Monticello, MN 55362-8929 | 2018-09-04 |
| 1609357524 | Nicole Marie Fox | Physician Assistant | 380 West 100 North, Monticello, UT 84535 | 2018-08-28 |
| 1053853234 | St Luke's Jones Regional Medical Center | Physician Assistant | 740 E Oak St, Monticello, IA 52310-1745 | 2016-11-05 |
| 1619421518 | Justyna Pachowska | Physician Assistant | 110 Bridgeville Rd, Monticello, NY 12701-3829 | 2016-08-09 |
| 1942670930 | Mississippi Em-i Medical Serives PC | Physician Assistant | 1065 E Broad St, Monticello, MS 39654-7703 | 2015-10-02 |
| Find all providers in MONTICELLO | ||||
| City | MONTICELLO |
| Zip Code | 31064 |
Please comment or provide details below to improve the information on ASHLEY SUZAM NORDSTROM.
| 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.