CSB OF EAST CENTRAL GEORGIA (NPI# 1659544369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659544369 |
| Entity Type | Organization |
| Organization Name | CSB OF EAST CENTRAL GEORGIA |
| Practice Address |
3421 Mike Padgett Hwy Augusta GA 30906-3815 |
| Practice Telephone | 7064324858 |
| Practice Fax Number | 7064323780 |
| Mailing Telephone | 7064324858 |
| Mailing Fax Number | 7064323780 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | WANDA JESSIE (BILLING SUPERVISOR) |
| Authorized Official Telephone | 7064324858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00605833E | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689945909 | Csb of East Central Georgia | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4054 Bath Edie Rd, Blythe, GA 30805-3600 | 2012-01-18 |
| 1447326541 | Csb of East Central Georgia | Clinic/Center | 1720 Central Ave, Augusta, GA 30904-5737 | 2006-11-28 |
| 1285700385 | Csb of East Central Georgia | Clinic/Center | 3405 Building #15, Augusta, GA 30906-3815 | 2006-11-28 |
| 1609942119 | Csb of East Central Georgia | Clinic/Center | 124 Gordon St, Washington, GA 30673-1602 | 2006-11-27 |
| Street Address |
3421 MIKE PADGETT HWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-3815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669456620 | Csb Community Mental Health Center of East Central Georgia | Clinic/Center | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2005-12-02 |
| 1609477033 | Toni Paschal | Marriage & Family Therapist | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-11-03 |
| 1457952897 | Michael Preddy | Counselor | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-11-03 |
| 1083221337 | Olusola Zainab Ajala | Registered Nurse | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-09-29 |
| 1356953715 | Monique Bramwell | Registered Nurse | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-08-18 |
| 1528695285 | Stephen Ray Martell | Counselor | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-03-24 |
| 1841826245 | Rachael L Fowler | Counselor | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-03-17 |
| 1992330914 | Kaylee D Ramos | Registered Nurse | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-03-10 |
| 1205461464 | Toni Akiti | Licensed Practical Nurse | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2020-03-09 |
| 1831737931 | Jessica Welichko | Registered Nurse | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2019-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653534 | Five Star Education Advocacy Group Inc | Clinic/Center | 978 Fellowship Rd, Fairburn, GA 30213-1789 | 2019-08-09 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1215420690 | Advantage Behavioral Health Systems | Clinic/Center | 1801 Prospect Rd., Madison, GA 30650 | 2018-06-11 |
| 1285149955 | Alicia Gordon | Clinic/Center | 132 Carol Cir, Fitzgerald, GA 31750-8128 | 2017-12-04 |
| 1225567597 | Vincentia Paul-constantin | Clinic/Center | 2867 Country House Lane, Buford, GA 30519 | 2017-06-08 |
| 1598158909 | Musik To Grow | Clinic/Center | 1517 Johnson Ferry Rd, Marietta, GA 30062-6493 | 2015-03-09 |
| 1356692800 | Ridgewood Personal Care Home, Inc | Clinic/Center | 1065 Murray Cir Sw, Marietta, GA 30064-3927 | 2012-09-24 |
| 1790055432 | Trapeze Therapy, LLC | Clinic/Center | 160 Tracy St, Suite A, Athens, GA 30601-1979 | 2012-01-11 |
| 1326316274 | Early/miller Day (now) | Clinic/Center | 302 Damacus Street, Blakely, GA 39823-3346 | 2011-12-07 |
| 1710255773 | Early Miller Personal Support (now) | Clinic/Center | 302 Damascus Street, Blakely, GA 39823-3346 | 2011-12-06 |
| 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.