KEMBERLY AMANDA STONE (NPI# 1639208333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639208333 |
| Entity Type | Individual |
| Full Name | KEMBERLY AMANDA STONE |
| Credential | PA-C |
| Practice Address |
453 Lakes Blvd Suite B Lake Park Family Care Clinic Lake Park GA 31636 |
| Mailing Address |
453 Lakes Blvd Suite B Lake Park GA 31636-6607 |
| Practice Telephone | 2295882866 |
| Mailing Telephone | 2295882866 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2018-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 05480 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA MEDICAL LICENSE NUMBER: 05480 EXPIRATION 01/31/2016 | 05480 | 01 |
| Street Address |
453 LAKES BLVD SUITE B LAKE PARK FAMILY CARE CLINIC |
| City | LAKE PARK |
| State | GA |
| Zip Code | 31636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891045191 | South Georgia Medical Center | General Acute Care Hospital | 2501 North Patterson St, Valdosta, GA 31636 | 2012-09-13 |
| 1407011711 | Migrant Farmworkers Clinic Inc | Clinic/Center | 224 J Frank Culpepper Road, Lake Park, GA 31636 | 2008-07-25 |
| 1649482795 | Institute for Family Systems Support | Social Worker | 308 West Collins Ave, Lake Park, GA 31636 | 2007-05-03 |
| 1215065768 | Dorothy B Price | Pharmacist | 1060 Lakes Boulevard, Winn Dixie #32, Lake Park, GA 31636 | 2007-02-28 |
| 1922163815 | South Health District | Public Health or Welfare | 751 Country Lane, Lake Park, GA 31636 | 2006-12-22 |
| 1235222415 | Wendy Ann Dorminey | Pharmacist | 1016 Lakes Blvd, Lake Park, GA 31636 | 2006-10-02 |
| 1528220308 | Michael Anthony Ferguson | Pharmacist | 1060 Lakes Blvd, Lake Park, GA 31636 | 2008-07-02 |
| 1285715433 | Manuel Tovar | Specialist | 224 Culpepper Rd., Lake Park, GA 31636-0889 | 2006-10-17 |
| 1518375815 | Rich Vodde | Social Worker | 5990 Dykes Pond Rd, Lake Park, GA 31636-2716 | 2014-07-30 |
| 1831671767 | Deborah Ann Woodward | Contractor | 612 Eagle Crest Dr, Lake Park, GA 31636-2751 | 2018-09-06 |
| Find all providers in zip 31636 | ||||
| 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 |
|---|---|---|---|---|
| 1881295657 | Hygeia Health Inc | Physician Assistant | 3983 Lavista Rd Ste 195, Tucker, GA 30084-5154 | 2020-11-06 |
| 1659970408 | Laura N Gillespie | Physician Assistant | 1800 Howell Mill Rd., Suite 450, Atlanta, GA 30318 | 2020-10-22 |
| 1306443346 | Margaret Howard | Physician Assistant | 1120 15th St # Ba8222, Augusta, GA 30912-0004 | 2020-10-02 |
| 1306453980 | Samantha Rose Ashmead | Physician Assistant | 2163 Mulberry St, East Point, GA 30344-1112 | 2020-09-28 |
| 1104433689 | Alexander Hartley Sprague | Physician Assistant | 244 13th St Ne Apt 208, Atlanta, GA 30309-3656 | 2020-09-28 |
| 1053928721 | Lynn Xinhui Guan | Physician Assistant | 1121 Johnson Ferry Rd Ste 420, Marietta, GA 30068-5420 | 2020-09-28 |
| 1285240010 | Kimberly Nicole Edwards Mclean | Physician Assistant | 516 Rocky Ridge Dr, Martinez, GA 30907-4988 | 2020-09-17 |
| 1588270391 | Buzzy Oguike | Physician Assistant | 4058 Akins Ridge Ct, Powder Springs, GA 30127-3272 | 2020-09-17 |
| 1972117919 | Gregory Zimmerman | Physician Assistant | 2669 Fleur De Lis Pl, Atlanta, GA 30360-1409 | 2020-09-08 |
| 1912511882 | Min Yang | Physician Assistant | 1076 Rolling Forest Ct, Lilburn, GA 30047-8931 | 2020-09-08 |
| 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.