DR. JERRY JOSEPH SMAHA (NPI# 1902882657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902882657 |
| Entity Type | Individual |
| Full Name | DR. JERRY JOSEPH SMAHA |
| Credential | MD |
| Practice Address |
2140 Riverside Dr Macon GA 31204 |
| Mailing Address |
4501 Russell Pkwy Ste 11 Warner Robins GA 31088 |
| Practice Telephone | 4789530024 |
| Practice Fax Number | 4789530675 |
| Mailing Telephone | 4789530024 |
| Mailing Fax Number | 4789530675 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2018-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
17087 | GA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
017087 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE | P00144376 | 01 |
| GA | 000093728K | 05 | |
| GA | 000093728Z | 05 |
| Street Address |
2140 RIVERSIDE DR |
| City | MACON |
| State | GA |
| Zip Code | 31204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609857317 | Northwest Diagnostic Imaging, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2005-11-09 |
| 1225376866 | Riverside Imaging Specialists, LLC | Clinic/Center | 2140 Riverside Dr, Suite B, Macon, GA 31204-1747 | 2013-01-16 |
| 1609009760 | Open Mri of Georgia, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2009-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134101199 | Mark Edward Barrow | Radiology | 770 Pine Street, Suite 290, Macon, GA 31201-7516 | 2005-11-16 |
| 1114908522 | Central Georgia Mri LLC | Radiology | 770 Pine St Ste L15, Attn: Radiology Department, Macon, GA 31201-7519 | 2005-11-11 |
| 1609857317 | Northwest Diagnostic Imaging, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2005-11-09 |
| 1437149762 | Central Georgia Pet LLC | Radiology | 1650 Hardeman Ave, Attn: Radiology Department, Macon, GA 31201-1418 | 2005-10-27 |
| 1326043688 | Arthur Hamilton Mccain | Radiology | 770 Pine St Ste 290, Attn: Radiology Department, Macon, GA 31201-7516 | 2005-06-14 |
| 1235423047 | Burton D Goodwin Jr. | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-06-09 |
| 1831495696 | Annie Lee Williams | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-01-26 |
| 1982922365 | Joshua Benjamin Cooper | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2010-05-11 |
| 1609009760 | Open Mri of Georgia, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2009-08-24 |
| 1194984583 | Alan D Kirsh | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2008-06-02 |
| Find all providers in MACON | ||||
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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.