ANTHONY J BONITATIBUS (NPI# 1689606477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689606477 |
| Entity Type | Individual |
| Full Name | ANTHONY J BONITATIBUS |
| Credential | MD |
| Practice Address |
1120 15th St Augusta GA 30912-0004 |
| Mailing Address |
1499 Walton Way Suite 1400 Augusta GA 30901-2602 |
| Practice Telephone | 7067246100 |
| Mailing Telephone | 7064211700 |
| Mailing Fax Number | 7068635418 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-12-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 51624 | GA | Allopathic & Osteopathic Physicians |
| N | 207K00000X | Allergy & Immunology | 45670 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 550638700 | 05 | |
| GA | 003121233A | 05 |
| Street Address |
1120 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
| 1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
| 1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
| 1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
| 1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
| 1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
| 1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
| 1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1144405705 | Mainegeneral Health Associates | Allergy & Immunology | 6 E Chestnut St, Augusta, ME 04330-5717 | 2008-01-02 |
| 1407058027 | Donnie P. Dunagan, M.d., P.C. | Allergy & Immunology | 2042 Central Ave, Augusta, GA 30904-4128 | 2007-06-05 |
| 1699886531 | Philip H. Smith | Allergy & Immunology | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-31 |
| 1508807751 | Scott Allen Dyer | Allergy & Immunology | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2006-06-09 |
| 1043260672 | Kathleen Ruffing May | Allergy & Immunology | 1120 15th St, Bg 1019, Augusta, GA 30912 | 2006-05-12 |
| 1184624876 | Michael Carver Belcon | Allergy & Immunology | 1120 15th St, Augusta, GA 30912-0004 | 2005-07-26 |
| 1649274630 | William Kennedy Dolen | Allergy & Immunology | 1120 15th St, Augusta, GA 30912-0004 | 2005-06-08 |
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|---|---|---|---|---|
| 1053935411 | St. Mary's Medical Group, Inc. | Allergy & Immunology | 1360 Caduceus Way Bldg 200-102, Watkinsville, GA 30677-7349 | 2020-06-02 |
| 1750902185 | Center for Allergy and Asthma Southern Crescent | Allergy & Immunology | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269-4794 | 2020-04-27 |
| 1003472036 | Annual Wellness Centers of America | Allergy & Immunology | 753 Old Norcross Rd Ste B, Lawrenceville, GA 30046-4312 | 2019-05-15 |
| 1821567371 | Breathe Better Allergy Asthma & Sinus Center, Inc | Allergy & Immunology | 950 S Enota Dr Ne Ste A, Gainesville, GA 30501-2439 | 2018-11-14 |
| 1982111316 | Sofia Miriam Sheikh | Allergy & Immunology | 4003 Oak Forest Dr Ne, Marietta, GA 30062-8022 | 2018-01-08 |
| 1366969560 | Allergy Consulting Group, LLC | Allergy & Immunology | 5752b Buford Hwy Ne, Doraville, GA 30340-1207 | 2017-08-28 |
| 1730597196 | Allergy Testing Solutions, LLC | Allergy & Immunology | 789 Hammond Dr, Unit 2510, Sandy Springs, GA 30328-8161 | 2014-07-30 |
| 1164863999 | Chih-yin Yeh | Allergy & Immunology | 5673 Peachtree Dunwoody Rd # 445, Atlanta, GA 30342-1731 | 2013-07-09 |
| 1023352069 | Advanced Allergy Inc | Allergy & Immunology | 5512 Glenridge Dr Ne, Unit A, Atlanta, GA 30342-7213 | 2012-11-15 |
| 1710246848 | Syeda Hamadani | Allergy & Immunology | 4700 Battlefield Pkwy Ste 300, Ringgold, GA 30736-5169 | 2012-05-09 |
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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.