MISS CHARLOTTE AMELIA EBNER (NPI# 1912228941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912228941 |
| Entity Type | Individual |
| Full Name | MISS CHARLOTTE AMELIA EBNER |
| Credential | D.O. |
| Practice Address |
2878 Five Forks Trickum Rd Lawrenceville GA 30044-5896 |
| Mailing Address |
2878 Five Forks Trickum Road Lawrenceville GA 30044 |
| Practice Telephone | 6783448700 |
| Practice Fax Number | 6783448600 |
| Mailing Telephone | 6783448700 |
| Mailing Fax Number | 6783448600 |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2017-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 069580 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 1390 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 013906 | 05 | |
| SC | RAILROAD MEDICARE | P01117581 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164965661 | Charlotte Ebner | Behavioral Analyst | 1101 W Moana Ln, Reno, NV 89509-4775 | 2016-12-01 |
| Street Address |
2878 FIVE FORKS TRICKUM RD |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30044-5896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013918721 | Pushpa Lalaji | Obstetrics & Gynecology | 2878 Five Forks Trickum Rd, 2a, Lawrenceville, GA 30044-5896 | 2005-08-03 |
| 1700058088 | Georgia Sleep Centers | Clinic/Center | 2878 Five Forks Trickum Rd, Suite 3a, Lawrenceville, GA 30044-5896 | 2008-03-27 |
| 1457523722 | Georgia Diagnostic Centers | Clinic/Center | 2878 Five Forks Trickum Rd, Suite 1a, Lawrenceville, GA 30044-5896 | 2008-03-27 |
| 1396895033 | Bradford M Gould | Family Medicine | 2878 Five Forks Trickum Rd, 2a, Lawrenceville, GA 30044-5896 | 2007-01-12 |
| 1750478525 | Richard Mcdonald Harris | Physician Assistant | 2878 Five Forks Trickum Rd, Lawrenceville, GA 30044-5896 | 2006-10-05 |
| 1629174123 | Robert G Whitener | Physician Assistant | 2878 Five Forks Trickum Rd, Suite 2a, Lawrenceville, GA 30044-5896 | 2006-09-15 |
| 1952316747 | Reagan Medical Center | Neurological Surgery | 2878 Five Forks Trickum Rd, Ste 2a, Lawrenceville, GA 30044-5896 | 2006-07-30 |
| 1518972496 | Kyle T Yandle | Physician Assistant | 2878 Five Forks Trickum Rd, Ste 2a, Lawrenceville, GA 30044-5896 | 2006-07-29 |
| 1083603922 | Satish B Poddar | Family Medicine | 2878 Five Forks Trickum Rd, Ste 2a, Lawrenceville, GA 30044-5896 | 2005-10-13 |
| 1407845340 | Archna Poddar | Internal Medicine | 2878 Five Forks Trickum Rd, Ste 2a, Lawrenceville, GA 30044-5896 | 2005-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740811892 | Berry and Mitchell Hands of Caring | Nurse's Aide | 1180 Market Square Lane, Lawrenceville, GA 30044 | 2020-01-28 |
| 1457995045 | Reagan Urgent Care | Clinic/Center | 2878 Five Forks Trickum Rd Ste 2a, Lawrenceville, GA 30044 | 2019-11-06 |
| 1194373621 | Kaseem Beck | Dentist | Gwinnett Family Dental Care, 3455 Lawrenceville Hwy, Lawrenceville, GA 30044 | 2019-08-28 |
| 1053965525 | Imani Anderson | Speech-Language Pathologist | 2775 Cruse Rd Suite 2002, Lawrenceville, GA 30044 | 2019-08-01 |
| 1598329625 | Zam Zam Family Clinic LLC | Clinic/Center | 965 Oakland Road, Bldg 3 Ste D & E, Lawrenceville, GA 30044 | 2019-04-24 |
| 1659858991 | Apex Eyecare | Optometrist | 3694 Club Drive Unit 101, Lawrenceville, GA 30044 | 2018-07-19 |
| 1538657549 | Georgia Comprehensive Family Clinic & Natural Health | Naturopath | 1065 Pleasant Hill Rd, Lawrenceville, GA 30044 | 2018-04-25 |
| 1316434095 | Children's Dentistry of Lithonia, LLC | Dentist | 4850 Sugarloaf Parkway, Ste 611, Lawrenceville, GA 30044 | 2018-04-18 |
| 1831619337 | Legacy Healthcare Services, Inc. | Occupational Therapist | 2899 Five Forks Trickum Rd Apt 204, Lawrenceville, GA 30044 | 2017-06-26 |
| 1326582859 | Ana Coronado | Social Worker | 965 Oakland Road Nw, Suite 3b, Lawrenceville, GA 30044 | 2016-12-19 |
| Find all providers in zip 30044 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669989422 | Choicemed Inc | Family Medicine | 3545 Cruse Rd Ste 100, Lawrenceville, GA 30044-3169 | 2018-01-02 |
| 1356705768 | Mark Adam Theodore Molckovsky | Family Medicine | 32 East Lawrence Road, Lawrenceville, PA 16929 | 2016-04-12 |
| 1902290570 | New League Family Practice | Family Medicine | 428 Waterbury Dr, Lawrenceville, GA 30046-3323 | 2015-03-23 |
| 1114347580 | Tik Pau | Family Medicine | 665 Duluth Hwy Ste 501, Lawrenceville, GA 30046-8709 | 2014-04-23 |
| 1346687696 | Paul Andrew Robertson | Family Medicine | 825 Meadowsong Cir, Lawrenceville, GA 30043-4236 | 2013-05-28 |
| 1952667388 | Alfred B. Amendolara Md, PC | Family Medicine | 2380 Lawrenceville Rd, Lawrenceville, NJ 08648 | 2012-04-10 |
| 1013200096 | Sana Rabbi | Family Medicine | 455 Philip Blvd, Ste 130, Kaiser Permanente Lawrenceville Medical Office, Lawrenceville, GA 30046 | 2011-05-24 |
| 1992021232 | Community Family Practice and Urgent Care P C | Family Medicine | 277 E Crogan St, Lawrenceville, GA 30046-5054 | 2010-04-12 |
| 1013148626 | Sheila Kennedy | Family Medicine | 1430 Five Forks Trickum Rd St 220, Lawrenceville, GA 30044-8182 | 2009-07-30 |
| 1366628117 | Nazra Baluch | Family Medicine | 1692 Atkinson Park Cir, Lawrenceville, GA 30043-7937 | 2008-01-10 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30044 |
Please comment or provide details below to improve the information on MISS CHARLOTTE AMELIA EBNER.
| 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.