COLLEEN MARIE KERRIGAN (NPI# 1679137038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679137038 |
| Entity Type | Individual |
| Full Name | COLLEEN MARIE KERRIGAN |
| Credential | PA |
| Practice Address |
303 Harris Industrial Blvd Ste 5 Vidalia GA 30474-8854 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 7707106712 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 9282 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Meadows Pkwy, Vidalia, GA 304748759 | 9125355555 | 9125355891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457614315 | Colleen Kerrigan | Specialist | 972 Hampshire Rd, Bay Shore, NY 11706-7633 | 2012-06-16 |
| 1942694492 | Colleen Blanchard Kerrigan | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Mailstop 341ba1, Burlington, VT 05401-1473 | 2015-03-23 |
| Street Address |
303 HARRIS INDUSTRIAL BLVD STE 5 |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-8854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912238460 | Bradley H Young | Nurse Practitioner | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2010-01-22 |
| 1861050890 | Esther J Galletta | Physician Assistant | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2019-06-04 |
| 1053814434 | Southeast Regional Primary Care Corporation | Urology | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| Find all providers in zip 30474 | ||||
| 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 |
|---|---|---|---|---|
| 1891132817 | Candice Stapleton Purvis | Physician Assistant | 303 Harris Industrial Blvd Ste 3, Vidalia, GA 30474-8854 | 2013-05-30 |
| 1225198823 | Alex Pierce | Physician Assistant | 1013 E 1st St, Vidalia, GA 30474-4227 | 2006-12-12 |
| 1962026013 | Alexis Joan Jackson | Physician Assistant | 303 Harris Industrial Blvd Ste 3, Vidalia, GA 30474-8854 | 2020-06-04 |
| 1023668894 | Hunter Dennard Richman | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2019-09-13 |
| 1861050890 | Esther J Galletta | Physician Assistant | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2019-06-04 |
| 1528447372 | Christina Michelle Tidwell | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-05-27 |
| 1427436393 | Archie Thomas Kirkley | Physician Assistant | 125 Church St, Vidalia, GA 30474-4770 | 2015-05-12 |
| 1750768032 | Montgomery Physician Services LLC | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-05-06 |
| 1750649653 | Zachary Jordan Whitaker | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2012-04-27 |
| 1861773764 | Montgomery Emergency Group, LLC | Physician Assistant | 1703 Meadows Ln, Vidalia, GA 30474-8915 | 2011-09-06 |
| Find all providers in VIDALIA | ||||
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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.