CHARLES S GERY JR. (NPI# 1962484915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962484915 |
Entity Type | Individual |
Full Name | CHARLES S GERY JR. |
Credential | PA-C |
Practice Address |
1802 Braeburn Dr Suite 1310 Salem VA 24153-7357 |
Mailing Address |
Po Box 277730 Atlanta GA 30384-7730 |
Practice Telephone | 5407762020 |
Practice Fax Number | 5407762017 |
Mailing Telephone | 6153737600 |
Enumeration Date | 2005-11-16 |
Last Update Date | 2009-03-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0110840469 | VA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MEDICARE RR | P00413631 | 01 | |
VA | 1962484915 | 05 | |
VA | RAILROAD MEDICARE | P00453914 | 01 |
Street Address |
1802 BRAEBURN DR SUITE 1310 |
City | SALEM |
State | VA |
Zip Code | 24153-7357 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134121338 | Mark R Hanabury Jr. | Specialist | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2005-06-01 |
1841851433 | Grace Julia Valiulis | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-06-24 |
1083279376 | Olivia Jayne Darwin | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-05-02 |
1487166088 | Christopher Cutchin Coulter | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-11-04 |
1063946358 | Kimberly Charise Martin | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-04-13 |
1699215434 | Shannon Michelle Snyder | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-02-27 |
1255875589 | Sarah Markwood | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-12-06 |
1437506789 | Nicole Crowder | Registered Nurse | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-05-17 |
1508228669 | Mohammed Abdul Khadar Siddiqui | Pediatrics | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-03-28 |
1851757629 | Alisha O Lipes | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-01-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
Find all providers in zip 24153 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245538990 | Megan S Welch | Physician Assistant | 16 Pelham Rd Ste 1, Salem, NH 03079 | 2011-03-04 |
1265971386 | Angela Rehder | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301 | 2017-02-22 |
1942757224 | Rebecca Theisen | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2016-09-05 |
1184965253 | Casey Lewis Shaw | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2013-03-13 |
1093062960 | Christopher J Shields | Physician Assistant | 16 Pelham Rd, Ste 1, Salem, NH 03079-2826 | 2012-08-10 |
1851658975 | Nicole L Kehrer | Physician Assistant | 1600 State St, Salem, OR 97301-4257 | 2012-04-13 |
1063795003 | Kevin Michael Dennis | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301-3975 | 2011-09-26 |
1386948347 | Timothy Tseng | Physician Assistant | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2011-01-05 |
1144520453 | Melissa Brooke Barone | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301-3975 | 2010-11-02 |
1700110616 | Dana Nicole Schenker | Physician Assistant | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2009-09-24 |
Find all providers in SALEM |
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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.