MR. MATTHEW R BOOTHBY (NPI# 1871828897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871828897 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW R BOOTHBY |
| Practice Address |
1111 Glynco Pkwy Ste 300 Brunswick GA 31525-7933 |
| Practice Telephone | 9122626552 |
| Practice Fax Number | 9122626599 |
| Mailing Telephone | 9122626552 |
| Mailing Fax Number | 9122626599 |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2015-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
005660 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1111 GLYNCO PKWY STE 300 |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-7933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477537660 | Anthony Mcpherson | Anesthesiology | 1111 Glynco Pkwy Ste 300, Brunswick, GA 31525-7933 | 2005-12-01 |
| 1285019018 | Guensley Ralph Delva | Anesthesiology | 1111 Glynco Pkwy Ste 300, Brunswick, GA 31525-7933 | 2015-07-22 |
| 1013230341 | Ardell Buckey Knight | Massage Therapist | 1111 Glynco Pkwy Ste 300, Brunswick, GA 31525-7933 | 2010-03-01 |
| 1447490776 | Christopher John Bovinet | Physical Medicine & Rehabilitation | 1111 Glynco Pkwy Ste 300, Brunswick, GA 31525-7933 | 2009-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003867086 | Callie Orae Mcmahon | Physician Assistant | 262 Church Rd, Brunswick, ME 04011-7302 | 2006-05-13 |
| 1619344223 | Elizabeth Blair Coleman | Physician Assistant | 2500 Starling St, Ste 403, Brunswick, GA 31520-4265 | 2015-08-31 |
| 1902001001 | Sandra S Daniell | Physician Assistant | 3217 4th St, Brunswick, GA 31520-3759 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748409 | Jesse Aaron Denson | Physician Assistant | 2046 Point Grey Ct Nw, Kennesaw, GA 30152-8276 | 2020-10-20 |
| 1568074227 | James D Craig | Physician Assistant | 3210 New College Way, Cumming, GA 30041-2896 | 2020-08-23 |
| 1982223244 | Keith Hawkins | Physician Assistant | 8498 Glenview St, Douglasville, GA 30134-5639 | 2020-04-15 |
| 1639704307 | Spectrum Surgical LLC | Physician Assistant | 3142 Highway 278 Nw # 135, Covington, GA 30014-2304 | 2020-03-03 |
| 1255962205 | Songthu Nguyen | Physician Assistant | 6119 Foxcroft Ct, Morrow, GA 30260-1069 | 2020-01-29 |
| 1265071229 | Stellar Surgical Assisting | Physician Assistant | 3446 Winder Hwy Ste M-322, Flowery Branch, GA 30542-3007 | 2019-12-22 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1710528401 | Hannah Ingrid Boomgarden | Physician Assistant | 1467 Harper Street Hb 5040, Augusta, GA 30912-5775 | 2019-10-03 |
| 1891257028 | Symmetry Surgical Billing LLC | Physician Assistant | 5135 Mirror Lake Dr, Cumming, GA 30028-7216 | 2019-04-05 |
| 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.