COOSA MEDICAL GROUP (NPI# 1821046863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821046863 |
| Entity Type | Organization |
| Organization Name | COOSA MEDICAL GROUP |
| Practice Address |
126 Three Rivers Dr Ne Rome GA 30161-4999 |
| Practice Telephone | 7062950070 |
| Practice Fax Number | 7062351618 |
| Mailing Telephone | 7062950070 |
| Mailing Fax Number | 7062351618 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MRS. NANCY C SMITH (OFFICE MANAGER) |
| Authorized Official Telephone | 7062385465 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 300029189A | 05 | |
| GA | 300029189C | 05 | |
| GA | RAILROAD MEDICARE GROUP# | CG3794 | 01 |
| Street Address |
126 THREE RIVERS DR NE |
| City | ROME |
| State | GA |
| Zip Code | 30161-4999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639153810 | Leone P Cordle | Physician Assistant | 126 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2005-12-01 |
| 1316226780 | Foot, Ankle & Leg Center of Rome LLC | Podiatrist | 126 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2011-08-16 |
| 1134103997 | William K Naguszewski | Psychiatry & Neurology | 126 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952830010 | Julie Olney | Specialist | 6459 Karlen Rd, Rome, NY 13440-7451 | 2017-06-12 |
| 1730531476 | Stuart Smith | Specialist | 22 Saddle Mountain Rd Se, Rome, GA 30161-6834 | 2016-07-06 |
| 1366618795 | Alberto L Larghi | Specialist | Largo A. Gemelli 8, Rome, ITALY 00168 | 2008-05-06 |
| 1437332517 | Ob Gyn Specialists of North Atlanta PC | Specialist | 330 Turner Mccall Blvd Sw Ste 105, Rome, GA 30165-5631 | 2007-12-11 |
| 1134145857 | Anand I Desai | Specialist | 1801 Black River Blvd N Ste 200, Rome, NY 13440-2427 | 2006-07-14 |
| 1033112438 | John J Desmond Iv | Specialist | 304 Shorter Ave Nw, Suite 201, Rome, GA 30165-4290 | 2005-05-31 |
| 1730665282 | Julie Ann Strzepek | Specialist | 130 Brookley Rd, Rome, NY 13441-4300 | 2018-07-18 |
| 1700254448 | Here We Are | Specialist | 91 Perimeter Rd, Suite 180, Rome, NY 13441-4018 | 2015-09-11 |
| 1992192645 | Tara Tucker | Specialist | 316 N Washington St, Rome, NY 13440-5121 | 2015-04-21 |
| 1295142057 | Jennifer Arcuri | Specialist | 130 Brookley Rd, Rome, NY 13441-4300 | 2014-07-14 |
| Find all providers in ROME | ||||
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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.