MEDICAL COLLEGE OF GEORGIA (NPI# 1609078047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609078047 |
| Entity Type | Organization |
| Organization Name | MEDICAL COLLEGE OF GEORGIA |
| Practice Address |
1120 15th St # Baa-5407 Augusta GA 30912-0004 |
| Practice Telephone | 7067212505 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | STEPHANIE FARROW (PA-C) |
| Authorized Official Telephone | 7067212505 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
4804 | GA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114138849 | Medical College of Georgia | Clinic/Center | Prison Rd, Sparta, GA 31081 | 2007-05-24 |
| 1285842856 | Medical College of Georgia | General Acute Care Hospital | 1423 Harper St, Augusta, GA 30912-0021 | 2007-05-18 |
| 1255454070 | Medical College of Georgia | Chronic Disease Hospital | 623 Walden Hills Cir, 623, Augusta, GA 30909-0223 | 2007-04-08 |
| 1568543551 | Medical College of Georgia | Specialist | 1120 15th St, Bp-2109, Augusta, GA 30912-0004 | 2006-10-18 |
| Street Address |
1120 15TH ST # BAA-5407 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417264292 | Angela Marie Barco | General Acute Care Hospital | 3486 Peach Orchard Rd Ste 200, Augusta, GA 30906 | 2010-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780046425 | Rasheeda Brown | General Acute Care Hospital | 362 E.g. Miles Parkway, Hinesville, GA 31310-0919 | 2016-03-22 |
| 1073927117 | Polk Medical Center, Inc | General Acute Care Hospital | 2360 Rockmart Hwy, Cedartown, GA 30125-6029 | 2014-06-17 |
| 1174800114 | Emory University Hospital | General Acute Care Hospital | 1355 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2011-11-04 |
| 1013211564 | Grady Health System | General Acute Care Hospital | 180 Victoria Dr, Fayetteville, GA 30214-1163 | 2010-12-26 |
| 1780880583 | Wheeler County Hospital | General Acute Care Hospital | 111 North 3rd Street, Glenwood, GA 30428 | 2007-06-27 |
| 1982821971 | Carl Vison Va Medical Center | General Acute Care Hospital | 48 Blueberry Farm Road, Adrian, GA 31002 | 2007-04-19 |
| 1326191180 | Professional Resources Management of Rabun, LLC | General Acute Care Hospital | 162 Legacy Pt, Clayton, GA 30525-5354 | 2007-01-18 |
| 1184771586 | Lower Oconee Community Hospital Inc | General Acute Care Hospital | 111 N 3rd Street, P O Bx 398, Glenwood, GA 30428 | 2007-01-05 |
| 1558423202 | Preferred Anesthesia Consultants | General Acute Care Hospital | 306 E 2nd Ave, Rome, GA 30161-3222 | 2006-12-15 |
| 1578637526 | Bleckley County Hospital | General Acute Care Hospital | 145 E Peacock St, Cochran, GA 31014-7846 | 2006-11-20 |
| 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.