JUAN ISRAEL GAITAN RUEDA (NPI# 1720241094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720241094 |
| Entity Type | Individual |
| Full Name | JUAN ISRAEL GAITAN RUEDA |
| Credential | MD |
| Practice Address |
1255 Highway 54 W Fayetteville GA 30214-4526 |
| Practice Telephone | 4043673014 |
| Mailing Telephone | 4043673014 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2017-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
076716 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
076716 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1255 HIGHWAY 54 W |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790759579 | Terrence Wise | Internal Medicine | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2006-02-16 |
| 1518575737 | Lillie La Marre | Anesthesiologist Assistant | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2020-07-14 |
| 1932723285 | Janam Nilesh Patel | Anesthesiologist Assistant | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2020-06-02 |
| 1851934541 | Kara Elizabeth Wright | Registered Nurse | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2019-10-24 |
| 1093370827 | Virginia Ann Horan | Physician Assistant | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2019-05-07 |
| 1588123285 | Morgan Roberson | Nurse Practitioner | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2019-03-13 |
| 1174099410 | Ellen Marie Morris-white | Nurse Practitioner | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2018-10-14 |
| 1851874085 | Monika Hill | Nurse Practitioner | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2018-09-13 |
| 1700368958 | Kristen Dawn Graddy | Occupational Therapist | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2018-09-04 |
| 1407342603 | Mary Grace B Nuega | Nurse Practitioner | 1255 Highway 54 W, Fayetteville, GA 30214-4526 | 2018-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1952643157 | Rahim Wooley | Internal Medicine | 1265 Highway 54 W Ste 500a, Fayetteville, GA 30214-4556 | 2013-03-26 |
| 1215463450 | Cumberland County Hospital System Inc | Internal Medicine | 1201 Walter Reed Rd, Fayetteville, NC 28304-4437 | 2017-05-09 |
| 1558701847 | Ashlie Arthur | Internal Medicine | 1265 Highway 54 W Ste 500a, Fayetteville, GA 30214 | 2013-07-01 |
| 1245243690 | Douglas Wayne Whetsell | Internal Medicine | 413 Owen Dr, Suite 202, Fayetteville, NC 28304-3489 | 2006-08-15 |
| 1699703496 | Jon A Sexton | Internal Medicine | 3344 N Futrall Dr, Fayetteville, AR 72703-4057 | 2006-06-29 |
| 1548298466 | Michael Alan Eckles | Internal Medicine | 3344 N Futrall Dr, Fayetteville, AR 72703 | 2006-06-29 |
| 1427094390 | Kyle G Hardy | Internal Medicine | 3344 N Futrall Dr, Fayetteville, AR 72703-4057 | 2006-06-21 |
| 1477599389 | Gary L Templeton | Internal Medicine | 3344 N Futrall Dr, Fayetteville, AR 72703-4057 | 2006-06-20 |
| 1003851072 | Kim R Agee | Internal Medicine | 3344 N Futrall Dr, Fayetteville, AR 72703-4057 | 2006-06-16 |
| 1821038209 | Rahul Kumar Kakkar | Internal Medicine | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-06-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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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.