TRACY PAVONE (NPI# 1881730984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881730984 |
| Entity Type | Individual |
| Full Name | TRACY PAVONE |
| Credential | AA |
| Practice Address |
3100 Kemble Ave Brunswick GA 31520-4211 |
| Mailing Address |
Po Box 235019 Montgomery AL 36123-5019 |
| Practice Telephone | 9122647000 |
| Mailing Telephone | 3342791450 |
| Mailing Fax Number | 3342791660 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2011-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 002697 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367H00000X | Anesthesiologist Assistant | 2697 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3100 KEMBLE AVE |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31520-4211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275504771 | Alta Anesthesia Associates of Georgia, PC | Physician Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2006-02-01 |
| 1154970564 | Adam Wesley Harper | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2019-09-09 |
| 1801353081 | Mallory B Harris | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2019-02-25 |
| 1093055501 | John D Porzio V | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2013-02-20 |
| 1699076463 | Christina E Squires | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2010-11-10 |
| 1689901282 | Michelle Denise Mann | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2009-11-03 |
| 1679719397 | Zachery A Barr | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2008-12-30 |
| 1235382185 | Timothy W Miller | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2008-10-23 |
| 1750549085 | Carol F Elliott | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2008-05-22 |
| 1255524138 | Allan Smith | Nurse Anesthetist, Certified Registered | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2007-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1063961845 | Irene Limon | Licensed Practical Nurse | 2009 Ellis Street, Brunswick, GA 31520 | 2016-09-22 |
| 1770936551 | Elaine Latimer-tandy | Counselor | 1801 Gloucester St Ste E, Brunswick, GA 31520 | 2016-07-18 |
| 1710336326 | Giva, Inc. | Home Health | 8 St Andrews Court, Brunswick, GA 31520 | 2016-06-06 |
| 1447618525 | Parmelee Eye Care LLC | Point of Service | 1909 Gloucester St, Brunswick, GA 31520 | 2016-02-04 |
| 1578947800 | Holly Diskin Kinsey | Nurse Practitioner | 3400 Parkwood Drive, Brunswick, GA 31520 | 2015-07-16 |
| 1679976419 | Miriam Hosey | Registered Nurse | 2747 Fourth Street, Glynn County Health Dept., Brunswick, GA 31520 | 2014-10-08 |
| 1558779348 | Tracey Renee Price | Internal Medicine | 3025 Shrine Rd Ste 290, Brunswick, GA 31520 | 2014-07-24 |
| 1770901951 | Candace Shepherd | Social Worker | 707 F Street, Brunswick, GA 31520 | 2014-04-03 |
| 1699193599 | Enrique Martinez, M.d., P.C. | Internal Medicine | 3114 A Shrine Road, Brunswick, GA 31520 | 2014-03-29 |
| Find all providers in zip 31520 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154817591 | Caroline Strickland Norris | Anesthesiologist Assistant | 2415 Parkwood Dr, Brunswick, GA 31520-4722 | 2018-07-09 |
| 1629478474 | James Kenneth Jones | Anesthesiologist Assistant | 2301 Parkwood Dr, Brunswick, GA 31520-4720 | 2014-08-29 |
| 1689901282 | Michelle Denise Mann | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2009-11-03 |
| 1235382185 | Timothy W Miller | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2008-10-23 |
| 1750549085 | Carol F Elliott | Anesthesiologist Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2008-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639784119 | Caroline N/a Guan | Anesthesiologist Assistant | 1377 Dresden Dr Ne Apt 5117, Brookhaven, GA 30319-3457 | 2020-09-11 |
| 1841815925 | Ghazal Motakef | Anesthesiologist Assistant | 365 Victorian Ln, Johns Creek, GA 30097-5769 | 2020-06-14 |
| 1801446455 | Mednax | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-16 |
| 1114570553 | Diana Ansley Berry | Anesthesiologist Assistant | 531 Roselane St Nw Ste 830, Marietta, GA 30060-6979 | 2019-07-23 |
| 1346703758 | Alexander Lee | Anesthesiologist Assistant | 1228 Christiana Xing, Lawrenceville, GA 30043-7007 | 2019-04-11 |
| 1710449897 | Salman Noorali Dewani | Anesthesiologist Assistant | 6371 Crestgate Ln, Tucker, GA 30084-8458 | 2019-04-05 |
| 1316432537 | Heather Mcintyre | Anesthesiologist Assistant | 57 Executive Park S Ste 300, Atlanta, GA 30329-2287 | 2018-06-29 |
| 1699292235 | Robin Spierer | Anesthesiologist Assistant | 80 Jesse Hill Jr Dr Se # 6d028, Atlanta, GA 30303-3031 | 2017-08-24 |
| 1821512401 | Stephen Chaussinand | Anesthesiologist Assistant | 5673 Peachtree Dunwoody Rd Ste 490, Atlanta, GA 30342-1775 | 2017-07-26 |
| 1790206381 | Andres Felipe Hernandez | Anesthesiologist Assistant | 80 Jesse Hill Jr Dr Se Ste 6d028, Atlanta, GA 30303-3031 | 2017-07-05 |
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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.