KENNETH JAY SOBEL (NPI# 1669478830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669478830 |
| Entity Type | Individual |
| Full Name | KENNETH JAY SOBEL |
| Credential | M.D. |
| Practice Address |
575 Professional Dr Ste 510 Lawrenceville GA 30045-3336 |
| Practice Telephone | 7705132072 |
| Practice Fax Number | 7705137986 |
| Mailing Telephone | 7705132072 |
| Mailing Fax Number | 7705137986 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2020-09-15 |
| NPI Deactivation Date | 03/16/2006 |
| NPI Reactivation Date | 2006-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 024099 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BCBSGA | 52067326 | 01 |
| GA | UHC,HUMANA, CIGNA | 581854158 | 01 |
| GA | 000435949B | 05 | |
| GA | TRICARE | 581854158001 | 01 |
| GA | AETNA | E00581854158 | 01 |
| GA | PALMETTO | 110064877 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356378939 | Kenneth Sobel | Pediatrics | 302 Hoffman St, Elmira, NY 14905-2263 | 2006-06-27 |
| Street Address |
575 PROFESSIONAL DR STE 510 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992241913 | Jemimah Miriam Varghese | Registered Nurse | 575 Professional Dr, Suite 165, Lawrenceville, GA 30046-3333 | 2017-01-14 |
| 1992161624 | Benita Merin Mathew | Anesthesiologist Assistant | 575 Professional Dr, #165, Lawrenceville, GA 30046-3333 | 2016-01-11 |
| 1811370737 | Gregg Snider | Anesthesiologist Assistant | 575 Professional Dr, Lawrenceville, GA 30046-3333 | 2015-07-09 |
| 1316293350 | Carolyn Lovejoy Stegall | Nurse Practitioner | 575 Professional Dr, #510, Lawrenceville, GA 30046-3333 | 2012-07-27 |
| 1487974853 | Mehdi Kazemzadeh, Optometrist, P C | Optometrist | 575 Professional Dr, 100, Lawrenceville, GA 30046-3333 | 2010-06-08 |
| 1033370762 | Bennett H. Bruckner,m.d., P.C. | Internal Medicine | 575 Professional Dr, Suite 290, Lawrenceville, GA 30045-3333 | 2008-06-25 |
| 1134390487 | Adult Primary Care Associates of Greater Gwinnett, LLC | Internal Medicine | 575 Professional Dr, Suite 510, Lawrenceville, GA 30045-3333 | 2008-03-14 |
| 1073716908 | Sleep Health Diagnostics, LLC. | Clinic/Center | 575 Professional Dr, Suite 260, Lawrenceville, GA 30046-3333 | 2007-06-07 |
| 1891902714 | Robert Emerson Ayer | Neurological Surgery | 575 Professional Dr, Suite 350, Lawrenceville, GA 30046-3333 | 2007-05-17 |
| 1194947630 | Mia M Mathewson | Anesthesiology | 575 Professional Dr, Ste 165, Lawrenceville, GA 30046-3333 | 2007-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420573 | Brenda Willis-wade | Internal Medicine | 1600 Keswick Place Dr, Lawrenceville, GA 30043-6627 | 2020-05-30 |
| 1780123588 | Feliks Shtindler Md PC | Internal Medicine | 3450 Princeton Pike, Suite 120, Lawrenceville, NJ 08648 | 2017-02-14 |
| 1902200835 | Odianosen I Obadan | Internal Medicine | 601 Professional Dr Ste 235a, Lawrenceville, GA 30046-7697 | 2014-10-21 |
| 1831416270 | Nidhip Anil Patel | Internal Medicine | 500 Medical Center Blvd Ste 310, Lawrenceville, GA 30046-3332 | 2010-04-26 |
| 1700108784 | North Atlanta Medical Clinic, L.l.c | Internal Medicine | 3664 Club Drive, Suite 201, Lawrenceville, GA 30044 | 2010-02-18 |
| 1932355294 | New Horizons Internal Medicine LLC | Internal Medicine | 771 Old Norcross Rd Ste 110, Lawrenceville, GA 30045-4317 | 2008-08-18 |
| 1376704106 | Samuel Deutsch Md PC | Internal Medicine | 316 W Pike St Ste 100, Lawrenceville, GA 30045-4878 | 2008-06-24 |
| 1033385877 | Neel Jitendra Gandhi | Internal Medicine | 2997 Princeton Pike, #201, Lawrenceville, NJ 08648 | 2008-05-01 |
| 1184899510 | Edward Joseph Ostrowski | Internal Medicine | 276 Fieldboro Dr, Lawrenceville, NJ 08648-3914 | 2008-04-27 |
| 1376717504 | Victorine Mafoueka Nguena | Internal Medicine | 3664 Club Dr Ste 201, Lawrenceville, GA 30044-2959 | 2008-04-18 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
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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.