MRS. KATHY S POODIACK


Address: 1700 Hospital South Drive, Suite 300, Austell, GA 30106-8116
Phone: 7709442830

MRS. KATHY S POODIACK (NPI# 1700030624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700030624
Entity Type Individual
Full Name MRS. KATHY S POODIACK
Other Name KATHY S ACKERMAN
Credential PA-C
Practice Address 1700 Hospital South Drive
Suite 300
Austell
GA 30106-8116
Practice Telephone 7709442830
Practice Fax Number 6785817170
Mailing Telephone 7709442830
Mailing Fax Number 6785817170
Enumeration Date 2008-11-05
Last Update Date 2009-11-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA9104850 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
GA STATE MEDICAL LICENSE 002325 01
GA MEDICARE, GROUP NUMBER GRP245 01

Office Location

Street Address 1700 HOSPITAL SOUTH DRIVE
SUITE 300
City AUSTELL
State GA
Zip Code 30106-8116

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336132158 Arun Chervu Surgery 1700 Hospital South Drive, Suite 502, Austell, GA 30106 2005-08-26
1790061034 Atlanta Prosthetics & Orthotics, Inc. Durable Medical Equipment & Medical Supplies 1700 Hospital South Drive, Suite 406, Austell, GA 30106 2011-11-01
1558487579 Shariq Sayeed Surgery 1700 Hospital South Drive, Suite 502, Austell, GA 30106-8159 2007-03-21
1700981099 Lisa Anne Oakley Internal Medicine 1700 Hospital South Drive, Suite 402, Austell, GA 30106 2006-09-13
1235234527 Mir Abid Husain Internal Medicine 1700 Hospital South Drive, Suite 402, Austell, GA 30106 2006-09-13
1144325432 Joseph Anthony Havlik Internal Medicine 1700 Hospital South Drive, Suite 402, Austell, GA 30106 2006-09-13
1437164159 Georgia Cancer Specialists I PC Internal Medicine 1700 Hospital South Drive, Suite 102, Austell, GA 30106-6810 2006-07-30
1982628590 Concord Inc Pharmacy 1700 Hospital South Drive, Suite 101, Austell, GA 30001 2006-07-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073126231 Courtney Lashune Dorsett Nurse Practitioner 1005 Cureton Drive, Austell, Austell, GA 30106 2020-08-27
1184240491 Brian H Eves Dietitian, Registered 3972 Brantley Drive, Austell, GA 30106 2020-06-23
1669014486 Jesse Mccoy Registered Nurse 3950 Austell Rd., Austell, GA 30106 2019-10-14
1427522820 Envision Optics LLC Optometrist 1680 E West Connector, Austell, GA 30106 2019-01-18
1972042380 Thomas Dental Group Clinic/Center 1133 East West Connector, Suite 120, Austell, GA 30106 2017-02-17
1245779792 Colton Dental Group Clinic/Center 2495 East-west Connector, Ste 60, Austell, GA 30106 2017-02-16
1144691684 Georgia Dental Professionals, PC Dentist 780 East West Connector Sw, Suite 108, Austell, GA 30106 2015-10-09
1285013714 Ikeade Bello Alamu Nurse Practitioner 2870 Betula Drive, Austell, GA 30106 2015-05-29
1376922211 Jessica Williams Obstetrics & Gynecology 1700 Hospital South Dr Ste 500, Austell, GA 30106 2015-05-26
1558799593 Tonya Renee Baldwin Speech-Language Pathologist 4229 Brass Trl., Austell, GA 30106 2013-10-30
Find all providers in zip 30106

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164057881 Aimberly Reshea Sanders Physician Assistant 1700 Hospital South Dr Ste 502, Austell, GA 30106-8159 2020-03-04
1013568104 Lauren Blessing Physician Assistant 1700 Hospital South Dr Ste 300, Austell, GA 30106-8116 2019-09-20
1588118483 Megan Rutherford Gaskin Physician Assistant 3820 Medical Park Dr, Austell, GA 30106-1110 2016-08-08
1740556380 Richard St. Charles Physician Assistant 3820 Medical Park Drive, Austell, GA 30106 2012-03-28
1467770156 Amber H Herring Physician Assistant 3820 Medical Park Dr, Austell, GA 30106-1110 2010-05-06
1205161965 Meghan R Kirkland Physician Assistant 3820 Medical Park Dr, Austell, GA 30106-1110 2009-10-13
1093955395 M. Luisa C Bowzard Physician Assistant 3820 Medical Park Dr, Austell, GA 30106-1110 2009-02-26
1316187610 Shari A Seaman Physician Assistant 3820 Medical Park Dr, Austell, GA 30106-1110 2009-02-26
1184781999 Patrick Derouen Physician Assistant 1550 Mulkey Rd, Austell, GA 30106-1112 2007-01-02
1588721393 Stacey K Mutz Physician Assistant 1550 Mulkey Rd, Austell, GA 30106-1112 2007-01-02
Find all providers in AUSTELL

Competitor

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City AUSTELL
Zip Code 30106

Improve Information

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Dataset Information

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.

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