KELLY RENAE GRUMMER-SMITH (NPI# 1619310802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619310802 |
| Entity Type | Individual |
| Full Name | KELLY RENAE GRUMMER-SMITH |
| Credential | NP-C |
| Practice Address |
39 Kent Rd Suite 5 Tifton GA 31794-1698 |
| Mailing Address |
907 18th St E Suite 150 Tifton GA 31794-3643 |
| Practice Telephone | 2293537337 |
| Mailing Telephone | 2293537337 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2015-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
545382 | CA | Nursing Service Providers |
| N | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
RN180155 | GA | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN180155 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
39 KENT RD SUITE 5 |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-1698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043203920 | Eric G Massa | Podiatrist | 39 Kent Rd, Suite 9, Tifton, GA 31794-1649 | 2005-08-26 |
| 1124679014 | Tift Regional Health System Inc | Family Medicine | 39 Kent Rd, Suite 2, Tifton, GA 31794-1697 | 2019-09-23 |
| 1891235131 | Ankle and Foot Assoc, LLC | Podiatrist | 39 Kent Rd, Suite 9, Tifton, GA 31794-1698 | 2017-03-06 |
| 1205290939 | Lauren B Saxena | Dietitian, Registered | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2016-04-08 |
| 1164857686 | Orthopedic Surgeons of Georgia, LLC | Clinic/Center | 39 Kent Rd, Tifton, GA 31794-1698 | 2013-09-04 |
| 1043552334 | Donna B Galliano | Nurse Practitioner | 39 Kent Rd, Suite 1, Tifton, GA 31794-1698 | 2013-03-25 |
| 1710224043 | Tift Regional Health System Inc | Family Medicine | 39 Kent Rd, Suite 1, Tifton, GA 31794-1698 | 2013-01-07 |
| 1093078388 | Bishara David Baddour | Obstetrics & Gynecology | 39 Kent Rd, Ste 1, Tifton, GA 31794-1698 | 2012-06-21 |
| 1285992073 | Kimberly Nicole Works | Pediatrics | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2012-04-30 |
| 1225354525 | Flavia S Rossi | Pediatrics | 39 Kent Rd, Suite 5, Tifton, GA 31794-1698 | 2010-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093080541 | Elizabeth L. Wilson | Nurse Practitioner | 2225 U S Highway 41 N, Tifton, GA 31794 | 2012-03-16 |
| 1427167899 | Carrie Lyn Parson | Nurse Practitioner | 2225 Us Highway 41 N, Tifton, GA 31794-2749 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565811 | Rebecca Danielle Wegman | Nurse Practitioner | 5445 Meridian Mark Rd Ste 380, Atlanta, GA 30342-4755 | 2020-10-09 |
| 1629675657 | Casey Cullins | Nurse Practitioner | 980 Johnson Fy Rd Ne Ste 680, Atlanta, GA 30342-1608 | 2020-10-02 |
| 1336755289 | Taylor Bishop | Nurse Practitioner | 51 Hidden Lake Ct, Savannah, GA 31419-1664 | 2020-09-16 |
| 1942815717 | Valerie Renee' Grenald | Nurse Practitioner | Augusta University Health, Augusta, GA 30912-0001 | 2020-09-09 |
| 1538798095 | Brittany Nicole Heitkamp | Nurse Practitioner | 5461 Meridian Mark Rd Ste 540, Atlanta, GA 30342-3283 | 2020-04-06 |
| 1629606421 | Anna Elizabeth Patton | Nurse Practitioner | 12 Sammy Mcghee Blvd Ste 102, Jasper, GA 30143-7712 | 2020-03-29 |
| 1093342131 | Lindsay Pare | Nurse Practitioner | 2225 Twin Lakes Dr, Atlanta, GA 30339-4123 | 2020-03-26 |
| 1215564976 | Stephanie Laurel Toole | Nurse Practitioner | 625 Big Shanty Rd Nw, Kennesaw, GA 30144-3646 | 2020-03-24 |
| 1740816487 | Aleksa Rozman | Nurse Practitioner | 1121 Johnson Ferry Rd Ste 220, Marietta, GA 30068-2763 | 2020-03-13 |
| 1912530866 | Rebecca L Brigola | Nurse Practitioner | 4120 Five Forks Trickum Rd Sw Ste 102, Lilburn, GA 30047-8975 | 2020-02-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KELLY RENAE GRUMMER-SMITH.
| 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.