MR. MICHAEL VICTOR SHIBLEY (NPI# 1750678843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750678843 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL VICTOR SHIBLEY |
| Credential | PA |
| Practice Address |
4791 S Main St Ste 100 Acworth GA 30101-5324 |
| Practice Telephone | 4042511600 |
| Practice Fax Number | 7704222340 |
| Mailing Telephone | 4042511600 |
| Mailing Fax Number | 7704222340 |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2017-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
006164 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4791 S MAIN ST STE 100 |
| City | ACWORTH |
| State | GA |
| Zip Code | 30101-5324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770909566 | Stacy L Cline | Nurse Practitioner | 4791 S Main St Ste 100, Acworth, GA 30101-5324 | 2014-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952931552 | A3j Incorporated | Registered Nurse | 3905 Cobb Pkwy Nw Ste 305, Acworth, GA 30101 | 2020-01-22 |
| 1043869852 | Sharron Leigh Lipscomb | Acupuncturist | 3661 Cedarcrest Rd Ste 320, Acworth, GA 30101 | 2019-09-05 |
| 1699322933 | Cowry Home Dialysis LLC | Durable Medical Equipment & Medical Supplies | 4450 Calibre Crossings Nw, Suite # 1122, Acworth, GA 30101 | 2019-08-21 |
| 1760979595 | Sandra Jeanetta Pugh | Counselor | 118 Clubhouse Crossing, Acworth, GA 30101 | 2018-04-17 |
| 1679926950 | Cindy Hatfield Fruits | Psychologist | 4839 N. Main Street, Acworth, GA 30101 | 2016-07-21 |
| 1396192563 | Philip Young | Specialist/Technologist | 4841 Lake Park Lane, Acworth, GA 30101 | 2016-05-18 |
| 1770960619 | Karen Fuller | Marriage & Family Therapist | 2487 Cedarcrest Rd Ste 722, Acworth, GA 30101 | 2015-04-29 |
| 1366830333 | Willard Hogan IIi | Physician Assistant | 1720 Mars Hill Rd Nw Ste 8-175, Acworth, GA 30101 | 2014-12-29 |
| 1386042083 | Sebastian Diaz Fischer | Chiropractor | 2639 Hickory Grove Rd, Suit 150, Ackworth, GA 30101 | 2014-12-11 |
| 1841699337 | J Chappell Md PC | Dermatology | 4450 Calibre Crossings, Suite 1208, Acworth, GA 30101 | 2014-08-20 |
| Find all providers in zip 30101 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609840511 | Lee Brian Brandt Jr. | Physician Assistant | 4900 Ivey Rd Nw, Suite 1826, Acworth, GA 30101-4001 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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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.