KANISHIA GORDON (NPI# 1912545393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912545393 |
| Entity Type | Individual |
| Full Name | KANISHIA GORDON |
| Credential | HAIR REPL SPECIALIST |
| Practice Address |
519 Memorial Dr Se Ste 209 Atlanta GA 30312-2286 |
| Mailing Address |
2025 Clearstream Overlook Stone Mountain GA 30088-4438 |
| Practice Telephone | 4048363845 |
| Mailing Telephone | 2035655872 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
519 MEMORIAL DR SE STE 209 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-2286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326661208 | Jasmine Dixon | Prosthetist | 390 Auburn Ave Ne, Atlanta, GA 30312-1544 | 2020-05-26 |
| 1790275337 | Angelique Crowder | Prosthetist | 375 Highland Ave Ne, Atlanta, GA 30312-1375 | 2018-05-17 |
| 1194221663 | Angela Slade | Prosthetist | 3645 Peachtree Rd Ne Apt 302, Atlanta, GA 30319-1275 | 2018-04-03 |
| 1407810880 | Georgia Prosthetics, Inc. | Prosthetist | 1947 Briarwood Ct, Ne, Atlanta, GA 30329-2006 | 2006-04-13 |
| 1073178893 | Salon Kairos LLC | Prosthetist | 1016 Howell Mill Rd Nw, Atlanta, GA 30318-5559 | 2019-05-07 |
| 1477875201 | Carolyn Denise Scott | Prosthetist | 577 Ralph Mcgill Blvd Ne, Atlanta, GA 30312-1110 | 2010-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152239 | Zachary T Hughes | Prosthetist | 1050 Barber Creek Dr Ste 103, Watkinsville, GA 30677-4502 | 2020-10-22 |
| 1306460662 | Unique Creationz Rx | Prosthetist | 2500 Dallas Hwy Sw Ste 202-1082, Marietta, GA 30064-2567 | 2020-06-02 |
| 1205450954 | Monique D Gay | Prosthetist | 2651 Favor Rd Sw # 1g06, Marietta, GA 30060-5241 | 2020-05-28 |
| 1134743891 | Jazmyn Monet Griffith | Prosthetist | 1564 Herrington Rd Apt 6112, Lawrenceville, GA 30043-7956 | 2020-05-28 |
| 1659900702 | Shirleysia Jones | Prosthetist | 213 Paces Commons Dr, Duluth, GA 30096-1712 | 2020-04-01 |
| 1922642826 | Juanita F Mike | Prosthetist | 6409 Guinness Ct, Union City, GA 30291-1991 | 2019-11-04 |
| 1003463787 | Denise Ann Hill | Prosthetist | 4308 Caveat Ct, Fairburn, GA 30213-4328 | 2019-08-19 |
| 1588224091 | Natalie Bennett | Prosthetist | 2864 Carrousel Ct, Stone Mountain, GA 30087-3922 | 2019-06-17 |
| 1235797051 | Latasha Paulette Gibbs | Prosthetist | 4955 Sugarloaf Pkwy Ste F, Lawrenceville, GA 30044-6997 | 2019-06-05 |
| 1477116648 | Patrice Sims | Prosthetist | 2148 Duluth Hwy Ste 108, Duluth, GA 30097-4504 | 2019-04-15 |
| 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.