ANNA MARIE BOGDANOV (NPI# 1629544358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629544358 |
| Entity Type | Individual |
| Full Name | ANNA MARIE BOGDANOV |
| Practice Address |
1900 Tebeau St Waycross GA 31501 |
| Mailing Address |
220 Riverside Ave Unit 653 Jacksonville FL 32202-4963 |
| Practice Telephone | 9122833030 |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2019-11-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 245 Oakland Pkwy Apt 1801, Leesburg, GA 317631838 | 4026895190 |
| Street Address |
1900 TEBEAU ST |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235112913 | James H Bloodworth | Pathology | 1900 Tebeau St, Waycross, GA 31501 | 2005-11-28 |
| 1740893148 | Colleen Chloe Mcconnell | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2020-08-25 |
| 1720619554 | Tierra Carter | Nurse Practitioner | 1900 Tebeau St, Waycross, GA 31501-6357 | 2020-01-30 |
| 1336791425 | Jana Revels | Nurse Practitioner | 1900 Tebeau St, Waycross, GA 31501-6357 | 2019-07-10 |
| 1174188668 | Carly Zoe Swett | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2019-05-09 |
| 1902374911 | Georgia Infectious Disease Consultants | Internal Medicine | 1900 Tebeau St, Waycross, GA 31501-6357 | 2018-11-07 |
| 1851869150 | Stacy Heather Exum Edgar | Nurse Practitioner | 1900 Tebeau St, Waycross, GA 31501-6357 | 2018-11-05 |
| 1831665389 | Mikayla Brittney Freeman | Physician Assistant | 1900 Tebeau St, Emergency Department, Waycross, GA 31501 | 2018-10-22 |
| 1306368329 | Carmen Yolanda Jackson | Nurse Practitioner | 1900 Tebeau St, Waycross, GA 31501-6357 | 2017-07-11 |
| 1518494871 | Anesthesia Physician Solutions of Georgia, LLC | Anesthesiology | 1900 Tebeau St, Waycross, GA 31501-6357 | 2017-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| 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 |
|---|---|---|---|---|
| 1740893148 | Colleen Chloe Mcconnell | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2020-08-25 |
| 1174188668 | Carly Zoe Swett | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2019-05-09 |
| 1780119487 | Morraine Hill Inpatient Services LLC | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2017-05-01 |
| 1780056648 | Hot Springs Emergency Physicians, LLC | Physician Assistant | 410 Darling Ave, Waycross, GA 31501-5246 | 2015-10-30 |
| 1699179663 | Margaret Bishop | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2014-10-20 |
| 1952743932 | David Robert Gill | Physician Assistant | 1900 Tebeau St, Satilla Mayo Emergency Department, Waycross, GA 31501-6357 | 2013-07-19 |
| 1700105194 | Charles W. Klein IIi | Physician Assistant | 218 Quarterman St, Waycross, GA 31501-3547 | 2010-05-25 |
| 1073837555 | Ricky O Tatum | Physician Assistant | 1007 Mary St, Waycross, GA 31503-3823 | 2010-03-26 |
| 1578750568 | Ashleigh Lewis Johnson | Physician Assistant | 1720 Old Reynolds St, Waycross, GA 31501 | 2007-10-03 |
| 1629283023 | William Stephen Hutcheson | Physician Assistant | 1908 Alice St, Waycross, GA 31501-6208 | 2007-05-11 |
| Find all providers in WAYCROSS | ||||
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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.