MRS. KATHRYN G BRADY (NPI# 1912123761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912123761 |
| Entity Type | Individual |
| Full Name | MRS. KATHRYN G BRADY |
| Credential | PAC |
| Practice Address |
104 Prominence Point Pkwy Suite 104 Canton GA 30114-1236 |
| Practice Telephone | 7707046988 |
| Mailing Telephone | 7707046988 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2016-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 003445 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386894897 | Kathryn Wright Brady | Speech-Language Pathologist | 3009 Skylark Dr, Columbia, MO 65203-3013 | 2008-09-22 |
| 1871915231 | Kathryn Brady | Developmental Therapist | 6867 Southpoint Dr N, Suite 101, Jacksonville, FL 32216-8043 | 2014-01-20 |
| Street Address |
104 PROMINENCE POINT PKWY SUITE 104 |
| City | CANTON |
| State | GA |
| Zip Code | 30114-1236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659467629 | Jeffrey Haller | Family Medicine | 104 Prominence Point Pkwy, Ste 104, Canton, GA 30114-1236 | 2006-10-05 |
| 1477978799 | Digestive Healthcare of Ga, P.C. | Internal Medicine | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2014-02-24 |
| 1043657521 | Ambreen Mardhani | Family Medicine | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2013-05-24 |
| 1013253103 | Amy Marie Wheeler | Nurse Practitioner | 104 Prominence Point Pkwy, Suite 104, Canton, GA 30114-1236 | 2012-12-18 |
| 1083778989 | Brenda Gail Fritz | Dentist | 104 Prominence Point Pkwy, Suite 102, Canton, GA 30114-1236 | 2006-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164048674 | Rebecca Lynn Yunk | Physician Assistant | 50433 Monroe St, Canton, MI 48188-6601 | 2020-06-20 |
| 1780210781 | Olivia Anastasia Basso | Physician Assistant | 4912 Higbee Ave Nw Ste 200, Canton, OH 44718-2599 | 2020-03-21 |
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1578113593 | Luiza Lica | Physician Assistant | 246 Princess Dr, Canton, MI 48188-1142 | 2019-09-12 |
| 1235614900 | Eva Louisa Paoloni | Physician Assistant | 1105 W Maple St Apt 3, Canton, OH 44720-2869 | 2018-09-28 |
| 1992281653 | Elizabeth Judy | Physician Assistant | 460 Northside Cherokee Blvd Ste 430, Canton, GA 30115-8020 | 2018-07-16 |
| 1083124051 | Stephanie Black | Physician Assistant | 1455 Harrison Ave Nw Ste 105, Canton, OH 44708-2609 | 2017-10-04 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1588111074 | Kinjal Shah | Physician Assistant | 43767 Ford Rd, Canton, MI 48187-3185 | 2016-09-01 |
| 1144683731 | Ellen Catherine Mitchell | Physician Assistant | 48575 Joy Rd, Canton, MI 48187-1214 | 2016-03-31 |
| Find all providers in CANTON | ||||
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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.