AMY DIETZ (NPI# 1861469488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861469488 |
| Entity Type | Individual |
| Full Name | AMY DIETZ |
| Credential | N.P. |
| Practice Address |
300 Hospital Rd Connelly Health Clinic Fort Gordon GA 30905-5650 |
| Practice Telephone | 7067875161 |
| Mailing Telephone | 7067875161 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2013-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN129166NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952533481 | Amy Michele Dietz | Physician Assistant | 525 Central Ave Ste D, Westfield, NJ 07090-2545 | 2009-08-17 |
| Street Address |
300 HOSPITAL RD CONNELLY HEALTH CLINIC |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386064053 | Gary Brunson | Registered Nurse | 300 Hospital Rd, Fort Gordon, GA 30905 | 2014-04-22 |
| 1366879470 | Vassie Beatrice Wade | Technician, Other | 300 Hospital Rd, Fort Gordon, GA 30905 | 2013-10-03 |
| 1790126209 | David Louis Anderson | Family Medicine | 300 Hospital Rd, Fort Gordon, GA 30905-5741 | 2013-07-12 |
| 1952654014 | Kenneth Alan Teuton | Pharmacist | 300 Hospital Rd, Interdisciplinary Pain Management Center, Fort Gordon, GA 30905-5741 | 2012-10-25 |
| 1346527561 | Ashley Nichole Davis | Counselor | 300 Hospital Rd, Fort Gordon, GA 30905 | 2011-11-16 |
| 1467769471 | Melissa S Gautreaux | Counselor | 300 Hospital Rd, Fort Gordon, GA 30905-5650 | 2010-09-13 |
| 1124291463 | Peter Shellabarger | Registered Nurse | 300 Hospital Rd, Fort Gordon, GA 30905 | 2008-04-08 |
| 1841461027 | Robert Douglas Rice | Surgery | 300 Hospital Rd, Dept. General Surgery, Fort Gordon, GA 30905 | 2008-03-17 |
| 1982713806 | Gary W Berg | Internal Medicine | 300 Hospital Rd, Bldg 40709, Fort Gordon, GA 30905-5650 | 2006-08-30 |
| 1710925805 | Lillian E Perez | Family Medicine | 300 Hospital Rd, Meb Section, Fort Gordon, GA 30905-5650 | 2006-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801446497 | Seth Randall | Nurse Practitioner | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-09-16 |
| 1518152776 | Romona Johnson | Nurse Practitioner | 300 East Hospital Road, Dwight D Eisenhower Army Medical Center Building, Fort Gordon, GA 30907 | 2007-09-11 |
| 1669491213 | Lavonnda N. Best | Nurse Practitioner | 300 W Hospital Rd, Dfcm, Fort Gordon, GA 30905-5741 | 2006-07-18 |
| 1952378564 | Donna Graham | Nurse Practitioner | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841186 | Cynthia Marie Benjamin Bates | Nurse Practitioner | 2746 Willis Foreman Rd, Hephzibah, GA 30815-6935 | 2020-11-06 |
| 1841891199 | Gloria Oduro | Nurse Practitioner | 983 Bentley Estates Dr, Dacula, GA 30019-7795 | 2020-11-03 |
| 1689274094 | Shundria Brown | Nurse Practitioner | 2122 Ellwyn Dr, Chamblee, GA 30341-1520 | 2020-10-27 |
| 1629677455 | Amy Lynn Patterson | Nurse Practitioner | 254 Senna St, Marietta, GA 30064-4417 | 2020-10-22 |
| 1538768965 | Tabitha Ford | Nurse Practitioner | 110 Shorter St Lot 9, Ty Ty, GA 31795-3179 | 2020-10-16 |
| 1902404320 | Shanelle Lynette Raiford | Nurse Practitioner | 2028 Hidden Meadow Ln, Stone Mountain, GA 30088-4448 | 2020-10-16 |
| 1760089072 | Diana Maresi Bulimu | Nurse Practitioner | 6050 Peachtree Pkwy # 240-178, Norcross, GA 30092-3336 | 2020-10-08 |
| 1760089692 | Natalie Xiomara Leak | Nurse Practitioner | 4855 Chesterfield Ct, Suwanee, GA 30024-1350 | 2020-10-05 |
| 1548877723 | Camille Watson-clarke | Nurse Practitioner | 3650 Steve Reynolds Blvd Ste 316, Duluth, GA 30096-4506 | 2020-09-30 |
| 1801403654 | Jacqueline Richart | Nurse Practitioner | 6300 Hospital Pkwy Ste 260, Johns Creek, GA 30097-1829 | 2020-09-25 |
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| City | FORT GORDON |
| Zip Code | 30905 |
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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.