TREVOR FREDERICK EZZELL (NPI# 1780847699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780847699 |
| Entity Type | Individual |
| Full Name | TREVOR FREDERICK EZZELL |
| Credential | FNP |
| Practice Address |
655 Jesse Jewell Pkwy Se Ste B Gainesville GA 30501-3854 |
| Mailing Address |
Po Box 658 Gainesville GA 30503-0658 |
| Practice Telephone | 7705327092 |
| Practice Fax Number | 7705360383 |
| Mailing Telephone | 7707181122 |
| Mailing Fax Number | 7705357445 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2012-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN152048 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 01228809 | 01 |
| GA | MEDICARE RAILROAD | P00903614 | 01 |
| GA | WELLCARE | 462656 | 01 |
| GA | 129681407C | 05 | |
| GA | 129681407A | 05 | |
| GA | 129681407B | 05 |
| Street Address |
655 JESSE JEWELL PKWY SE STE B |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356336606 | James Ross Davis | Specialist/Technologist | 655 Jesse Jewell Pkwy Se, Gainesville, Gainesville, GA 30501-3722 | 2005-09-13 |
| 1053899682 | Hugh Colby Cornelson | Nurse Practitioner | 655 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3756 | 2018-08-06 |
| 1396141974 | John Richard Williams I | Physician Assistant | 655 Jesse Jewell Pkwy Se, Suite B, Gainesville, GA 30501 | 2014-11-10 |
| 1033511209 | Jeremiah John Spearman | Physician Assistant | 655 Jesse Jewell Pkwy Se, Ste B, Gainesville, GA 30501-3854 | 2014-09-19 |
| 1801146402 | Karen Jeanette Freeman | Nurse Practitioner | 655 Jesse Jewell Pkwy Se, Ste B, Gainesville, GA 30501 | 2012-09-12 |
| 1417247073 | Christopher David Thomas | Physician Assistant | 655 Jesse Jewell Pkwy Se, Ste B, Gainesville, GA 30501-3756 | 2011-04-15 |
| 1861647836 | Seth Abraham Alhadeff | Physical Therapist | 655 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3756 | 2008-11-18 |
| 1568627412 | Jason Jamesryan Rutland Nierenhausen | Specialist/Technologist | 655 Jesse Jewell Pkwy Se, Suite C, Gainesville, GA 30501-3756 | 2008-07-21 |
| 1609049089 | Kelly Everett Hemphill | Physician Assistant | 655 Jesse Jewell Pkwy Se, Ste B, Gainesville, GA 30501-3756 | 2008-04-08 |
| 1740452465 | Diane C Kelly Dmd, PC | Dentist | 655 Jesse Jewell Pkwy Se, Gainesville, GA 30501 | 2008-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908446 | Jade Asante-selby | Nurse Practitioner | 3030 Mcever Rd Ste 130, Gainesville, GA 30504-5538 | 2020-09-28 |
| 1295349405 | Mildred K Myrtil | Nurse Practitioner | 3754 Nw 54th Ln, Gainesville, FL 32653-0859 | 2020-09-04 |
| 1821608712 | Talia Rose Maschino | Nurse Practitioner | 1430 Se 51st St, Gainesville, FL 32641-1962 | 2020-08-05 |
| 1760006282 | Chariza Parsons Lopez | Nurse Practitioner | 8340 Nw 51st St, Gainesville, FL 32653-6182 | 2020-06-01 |
| 1255961017 | Whitney Necole Mcneely | Nurse Practitioner | 3009 Sw Williston Rd, Gainesville, FL 32608-3928 | 2020-01-21 |
| 1255961249 | Jared David Mincey | Nurse Practitioner | 10405 Sw 122nd St, Gainesville, FL 32608-5843 | 2020-01-19 |
| 1346870565 | Emily Grace Holbrook | Nurse Practitioner | 650 Crestview Ter, Gainesville, GA 30501-3110 | 2020-01-16 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1124676218 | Fasika T Enyew | Nurse Practitioner | 1870 Atlanta Hwy, Gainesville, GA 30504-5948 | 2019-08-31 |
| 1821641416 | Julie Tiegs | Nurse Practitioner | 5431 Little River Cir, Gainesville, GA 30506-3191 | 2019-07-22 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
Please comment or provide details below to improve the information on TREVOR FREDERICK EZZELL.
| 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.