MELINDA MATHERLY LAVECCHIA (NPI# 1932625209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932625209 |
| Entity Type | Individual |
| Full Name | MELINDA MATHERLY LAVECCHIA |
| Credential | PA |
| Practice Address |
114 Canal St Ste 503 Pooler GA 31322 |
| Mailing Address |
114 Canal St Ste 503 Pooler GA 31322-4261 |
| Practice Telephone | 9124506300 |
| Practice Fax Number | 9124506303 |
| Mailing Telephone | 9124506300 |
| Mailing Fax Number | 9124506303 |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2020-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 008534 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 114 Canal St Ste 503, Pooler, GA 31322 | 9124506300 |
| Street Address |
114 CANAL ST STE 503 |
| City | POOLER |
| State | GA |
| Zip Code | 31322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356761191 | Simon Matt Willis | Physical Medicine & Rehabilitation | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2014-04-20 |
| 1164958146 | Spectrum Medical Solutions, LLC | Pain Medicine | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427518745 | Quinate Pharmacy LLC | Pharmacy | 1557 Pooler Pkwy, Suite 400, Pooler, GA 31322 | 2019-03-22 |
| 1396202495 | Rucker Holdings | Durable Medical Equipment & Medical Supplies | 210 Grand Central Blvd, Pooler, GA 31322 | 2019-02-25 |
| 1306301841 | Altamaha Dme, Inc | Durable Medical Equipment & Medical Supplies | 1557 Pooler Parkway, Suite 300, Pooler, GA 31322 | 2019-02-08 |
| 1750859351 | Bombery Chiropractic LLC | Chiropractor | 122 Canal St. Ste 109, Pooler, GA 31322 | 2018-11-13 |
| 1407347891 | Georgia Dental Professionals, PC | Dentist | 2140 Pooler Pkwy, Pooler, GA 31322 | 2018-05-22 |
| 1730685439 | Monali Patel | Optometrist | 276 Pooler Pkwy Ste B, Pooler, GA 31322 | 2018-04-02 |
| 1144747023 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 101 Blue Moon Crossing, Pooler, GA 31322 | 2017-08-23 |
| 1063932408 | The Range Physical Therapy, LLC | Clinic/Center | 10801 County Line Rd, Madison, AL 31322 | 2017-06-27 |
| 1285154427 | Pooler Physical Therapy LLC | Clinic/Center | 101 Shepherd Way, Pooler, GA 31322 | 2017-06-20 |
| 1578009130 | Georgia Cvs Pharmacy L.l.c | Durable Medical Equipment & Medical Supplies | 500 Pooler Pkwy, Pooler, GA 31322 | 2017-01-06 |
| Find all providers in zip 31322 | ||||
| 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 |
|---|---|---|---|---|
| 1285247700 | Carissa Fischer | Physician Assistant | 280 Blue Moon Xing Apt 331, Pooler, GA 31322-7608 | 2020-08-25 |
| 1306475975 | Beatriz Aponte-torres | Physician Assistant | 17 Marshland Pointe, Pooler, GA 31322-3685 | 2020-04-06 |
| 1912405564 | James B Jones | Physician Assistant | 326 Casey Dr, Pooler, GA 31322-9449 | 2018-01-29 |
| 1932297967 | Cheri K. Johnson | Physician Assistant | 171 Village Lake Dr, Pooler, GA 31322-2147 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295657 | Hygeia Health Inc | Physician Assistant | 3983 Lavista Rd Ste 195, Tucker, GA 30084-5154 | 2020-11-06 |
| 1659970408 | Laura N Gillespie | Physician Assistant | 1800 Howell Mill Rd., Suite 450, Atlanta, GA 30318 | 2020-10-22 |
| 1306443346 | Margaret Howard | Physician Assistant | 1120 15th St # Ba8222, Augusta, GA 30912-0004 | 2020-10-02 |
| 1306453980 | Samantha Rose Ashmead | Physician Assistant | 2163 Mulberry St, East Point, GA 30344-1112 | 2020-09-28 |
| 1104433689 | Alexander Hartley Sprague | Physician Assistant | 244 13th St Ne Apt 208, Atlanta, GA 30309-3656 | 2020-09-28 |
| 1053928721 | Lynn Xinhui Guan | Physician Assistant | 1121 Johnson Ferry Rd Ste 420, Marietta, GA 30068-5420 | 2020-09-28 |
| 1285240010 | Kimberly Nicole Edwards Mclean | Physician Assistant | 516 Rocky Ridge Dr, Martinez, GA 30907-4988 | 2020-09-17 |
| 1588270391 | Buzzy Oguike | Physician Assistant | 4058 Akins Ridge Ct, Powder Springs, GA 30127-3272 | 2020-09-17 |
| 1972117919 | Gregory Zimmerman | Physician Assistant | 2669 Fleur De Lis Pl, Atlanta, GA 30360-1409 | 2020-09-08 |
| 1912511882 | Min Yang | Physician Assistant | 1076 Rolling Forest Ct, Lilburn, GA 30047-8931 | 2020-09-08 |
| 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.