NICOLE MIDDLEBROOK (NPI# 1568987600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568987600 |
| Entity Type | Individual |
| Full Name | NICOLE MIDDLEBROOK |
| Credential | EMT-I |
| Practice Address |
1174 Forest Pkwy Lake City GA 30260-3471 |
| Mailing Address |
Po Box 1132 Forest Park GA 30298-1132 |
| Practice Telephone | 6788789834 |
| Mailing Telephone | 6788789834 |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146D00000X | Personal Emergency Response Attendant | GA | Emergency Medical Service Providers | |
| N | 146M00000X | Emergency Medical Technician, Intermediate | GA | Emergency Medical Service Providers | |
| N | 172A00000X | Driver | Other Service Providers | ||
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
39499 | GA | Allopathic & Osteopathic Physicians |
| N | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
1174 FOREST PKWY |
| City | LAKE CITY |
| State | GA |
| Zip Code | 30260-3471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942460019 | Dinkins Nutrition Consultant Services Lls | Exclusive Provider Organization | 1174 Forest Pkwy, Suite E3, Lake City, GA 30260-3471 | 2008-06-12 |
| 1306361449 | Dana Florence | Registered Nurse | 1174 Forest Pkwy, Lake City, GA 30260-3471 | 2017-08-10 |
| 1629593827 | Just Like Family of Ga., LLC | Home Health | 1174 Forest Pkwy, Lake City, GA 30260-3471 | 2017-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675956 | Nextgen Ems LLC | Emergency Medicine | 121 Tyre Dr, Mcdonough, GA 30253-8542 | 2020-09-29 |
| 1710506233 | Rita Udom | Emergency Medicine | 2795 Davis Rd, Marietta, GA 30062-6670 | 2020-04-14 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1831539253 | Andrew Wesley White | Emergency Medicine | 1120 15th St # Af1006, Augusta, GA 30912-4500 | 2013-06-29 |
| 1013141118 | Darren Deandre Naugles | Emergency Medicine | 8920 Firestone Cir, Duluth, GA 30097-6627 | 2009-05-05 |
| 1437393667 | Donald R. Dalbey | Emergency Medicine | 3725 Sweetwater Drive, Cumming, GA 30041 | 2009-05-01 |
| 1346411667 | Harvey E Schuck | Emergency Medicine | 427 Brentwood Dr Ne, Atlanta, GA 30305-3204 | 2008-03-14 |
| 1639364011 | Srihari Rao Malempati | Emergency Medicine | 535 Trimble Lake Ct Ne, Atlanta, GA 30342-2481 | 2007-09-10 |
| 1306060264 | Gary L Godlewski | Emergency Medicine | 4755 Wesleyan Woods Dr, Macon, GA 31210-4410 | 2007-04-12 |
| 1710030002 | Robert Lee Carlson Jr. | Emergency Medicine | 3900 Legacy Park Blvd Nw, Suite C-100, Kennesaw, GA 30144-7412 | 2007-01-19 |
| 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.