BONITA L BROCKMAN (NPI# 1962443515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962443515 |
| Entity Type | Individual |
| Full Name | BONITA L BROCKMAN |
| Other Name | EVAN LAVONNE BROCKMAN |
| Credential | MD |
| Practice Address |
2041 Mesa Valley Way Ste 185 Austell GA 30106 |
| Mailing Address |
361 Nelms Ave Atlanta GA 30307 |
| Practice Telephone | 4047858900 |
| Practice Fax Number | 4047858948 |
| Mailing Telephone | 4048227712 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 045410 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
2041 MESA VALLEY WAY STE 185 |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366444929 | East West Surgery Center Lp | Clinic/Center | 2041 Mesa Valley Way, Ste 125, Austell, GA 30106-6828 | 2005-08-12 |
| 1780042333 | Curtis Anthony Peoples Jr. | Physician Assistant | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2016-02-10 |
| 1487011771 | April Amaral | Physician Assistant | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2016-01-19 |
| 1174919880 | Kyle Spinrad | Physician Assistant | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2015-04-09 |
| 1750717310 | Tor K. Robinson | Physician Assistant | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2013-09-16 |
| 1821369448 | Mak Anesthesia Ewsc LLC | Anesthesiology | 2041 Mesa Valley Way, Ste 125, Austell, GA 30106-6828 | 2012-01-13 |
| 1710206214 | Mikael Starecki | Orthopaedic Surgery | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106 | 2010-05-24 |
| 1326276734 | Angela Josephine Lucier | Physical Therapist | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2009-06-24 |
| 1467688085 | Marly N. Dows-martinez | Physical Medicine & Rehabilitation | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2009-06-10 |
| 1063625051 | Jeffrey N Hairston | Physician Assistant | 2041 Mesa Valley Way, Suite 100, Austell, GA 30106-6828 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083762025 | Kimberly N Hodge Spears | Pediatrics | 3640 Tramore Pointe Parkway Sw, Department of Pediatrics, Austell, GA 30106 | 2007-01-08 |
| 1205826500 | Shelly-ann Michela Salandy | Pediatrics | 1680 Mulkey Rd, Suite E, Austell, GA 30106-1118 | 2005-10-27 |
| 1760831069 | Neena Alex | Pediatrics | 3950 Austell Rd, Austell, GA 30106-1121 | 2016-06-07 |
| 1003176082 | Joli Ann Mccarthy | Pediatrics | 3950 Austell Rd, Austell, GA 30106-1121 | 2012-05-23 |
| 1184908188 | Children's Medical Associates, LLC | Pediatrics | 1680 Mulkey Rd, Suite E, Austell, GA 30106-1118 | 2011-10-10 |
| 1073819124 | Wellstar Medical Group, LLC | Pediatrics | 1810 Mulkey Rd, Suite 201, Austell, GA 30106-1151 | 2011-02-08 |
| 1942527684 | Saira I Alimohamed | Pediatrics | 3950 Austell Rd # 22, Austell, GA 30106 | 2010-04-20 |
| 1508987793 | Ronnika C Harley | Pediatrics | 1810 Mulkey Rd, Suite 201, Austell, GA 30106-1151 | 2007-04-03 |
| 1083756894 | Kelly Solms Garrison | Pediatrics | 3950 Austell Rd # 22, Austell, GA 30106 | 2007-02-12 |
| 1376649871 | Jennifer N Vernon | Pediatrics | 1810 Mulkey Rd, Suite 201, Austell, GA 30106-1151 | 2006-09-15 |
| Find all providers in AUSTELL | ||||
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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.