SAMANTHA BROOKE LEDBETTER (NPI# 1841794757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841794757 |
| Entity Type | Individual |
| Full Name | SAMANTHA BROOKE LEDBETTER |
| Credential | NP |
| Practice Address |
3575 Braselton Hwy Dacula GA 30019 |
| Mailing Address |
Po Box 742616 Atlanta GA 30374-2616 |
| Practice Telephone | 7708485300 |
| Practice Fax Number | 7708485301 |
| Mailing Telephone | 7702198420 |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | RN230690 | GA | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN230690 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RN230690 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1061 Dowdy Rd Ste 101, Athens, GA 306065700 | 7066217575 |
| Street Address |
3575 BRASELTON HWY |
| City | DACULA |
| State | GA |
| Zip Code | 30019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982679684 | John Michael Buchanan | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1155 | 2006-02-17 |
| 1295199677 | Elvira Jasarevic | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2016-04-11 |
| 1629443106 | Kate Anderson Bass | Social Worker | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2015-12-09 |
| 1871789271 | Jody Marie Bahnmiller-brasil | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2007-09-19 |
| 1669673331 | Holly Davidson Corley | Internal Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2007-05-30 |
| 1740332840 | Inchol Yun | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564525 | Amy Elizabeth Hicks | Nurse Practitioner | 3046 Holden Spring Ct, Dacula, GA 30019-1896 | 2020-10-02 |
| 1366071698 | Elizabeth Smith Elmadolar | Nurse Practitioner | 2137 Bakers Mill Rd, Dacula, GA 30019-4623 | 2020-04-07 |
| 1073152963 | Allisan Faye Meadows | Nurse Practitioner | 465 Dacula Rd Ste I, Dacula, GA 30019-2171 | 2019-12-25 |
| 1881256238 | Katherine Tope Adeojo | Nurse Practitioner | 2935 Evergreen Eve Xing, Dacula, GA 30019-3141 | 2019-07-06 |
| 1568947869 | Weks Wekongho Anyu-chita | Nurse Practitioner | 1934 Acorn Ln, Dacula, GA 30019-7917 | 2018-10-02 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1215421847 | Nnenna Elizabeth Onyeukwu | Nurse Practitioner | 2900 Austin Ridge Dr, Dacula, GA 30019-6114 | 2018-06-18 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1841652328 | Laura L Orlando | Nurse Practitioner | 2290 Beckenham Pl, Dacula, GA 30019-6745 | 2016-03-24 |
| 1518328848 | Ann-marie D Dixon | Nurse Practitioner | 2971 Belfaire Lake Dr, Dacula, GA 30019-6727 | 2016-03-15 |
| Find all providers in DACULA | ||||
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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.