EASTSIDE SURGICAL ASSISTANTS LLC (NPI# 1962872218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962872218 |
| Entity Type | Organization |
| Organization Name | EASTSIDE SURGICAL ASSISTANTS LLC |
| Practice Address |
925 Main St Suite 300-07 Stone Mountain GA 30083-3098 |
| Practice Telephone | 6787992498 |
| Mailing Telephone | 6787992498 |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |
| Authorized Official Name | MR. SAMUEL FENDERSON (CERTIFIED SURGICAL ASSISTANT) |
| Authorized Official Telephone | 6787992498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
925 MAIN ST SUITE 300-07 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30083-3098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205295425 | Prn Sitters, LLC | Home Health | 925 Main St, Suite 300-21, Stone Mountain, GA 30083-3098 | 2016-02-16 |
| 1841486305 | Georgia Youth Network Inc | Community/Behavioral Health | 925 Main St, Suite 104, Stone Mountain, GA 30083-3098 | 2007-09-19 |
| 1043385131 | Tonya Grissam | Pediatrics | 925 Main St, Stone Mountain, GA 30083-3098 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1710403431 | Trans Med Ems,llc | Ambulance | 4683 Redan Rd, Stone Mountain, GA 30083 | 2017-08-15 |
| 1447770482 | Dispatched Angels Home Care | In Home Supportive Care | 619 El Prado Court, Stone Mountain, GA 30083 | 2017-06-21 |
| 1396191086 | Suzanne Carter | Chore Provider | 1036 Allgood Rd, Stone Mountain, GA 30083 | 2016-05-11 |
| 1437520087 | Meaza Dada | Pharmacist | 1043 Thornwoode Lane, Stone Mountain, GA 30083 | 2015-10-08 |
| 1427436500 | Raeanne Elizabeth Gialanella | Occupational Therapist | 5839 Memorial Drive, Stone Mountain, GA 30083 | 2015-05-11 |
| 1265829824 | Latore Williams | Licensed Practical Nurse | 5300 Ridge Forest Drive, Stone Mountain, GA 30083 | 2015-04-22 |
| 1144625922 | Granville Theodore Freeman IIi | Counselor | 5000 Brittany Drive, Stone Mountain, GA 30083 | 2014-10-23 |
| 1588974208 | Terri R Collins | Counselor | 1020 Strap Hinge Trail, Stone Mountain, GA 30083 | 2010-10-15 |
| 1104064815 | Vistas Medical Center,pc | Clinic/Center | 5329 Memorial Dr Ste A, Stone Mountain, GEORGIA 30083 | 2009-02-03 |
| Find all providers in zip 30083 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490352 | Kimberly Simms | Specialist/Technologist, Other | 5081 Conestoga Ct, Stone Mountain, GA 30087-4053 | 2016-03-28 |
| 1447560073 | Robin A Melroy | Specialist/Technologist, Other | 2231 Deer Ridge Dr, Stone Mountain, GA 30087-1129 | 2010-10-18 |
| 1578034732 | Tl Surgical Assisting LLC | Specialist/Technologist, Other | 6301 Southland Rdg, Stone Mountain, GA 30087-4996 | 2018-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818422 | Lisa M Arey | Specialist/Technologist, Other | 2429 Salem Ct Sw, Marietta, GA 30064-4259 | 2020-07-21 |
| 1457972309 | Shanon Marie Roderick | Specialist/Technologist, Other | 115 Bradford Ct, Savannah, GA 31406-4122 | 2020-05-01 |
| 1659990869 | Katrina A Toler | Specialist/Technologist, Other | Optim Medical Center - Tattnall, 247 S Main Street, Reidsville, GA 30453 | 2020-04-09 |
| 1295360311 | Taryn Shumaker | Specialist/Technologist, Other | 715 Cedar Valley Trce, Lawrenceville, GA 30043-2424 | 2020-03-09 |
| 1003448911 | Kirstin Gabler | Specialist/Technologist, Other | 2119 Wilshire Dr Sw, Marietta, GA 30064-4197 | 2020-02-08 |
| 1982244257 | Chad Seawright | Specialist/Technologist, Other | 1765 Old West Broad St Bldg 2-200, Athens, GA 30606-2887 | 2020-01-14 |
| 1952948945 | Haley Johnson | Specialist/Technologist, Other | 619 Minter Rd, Griffin, GA 30223-5635 | 2019-12-09 |
| 1215579982 | Anfernee Jerome Walker | Specialist/Technologist, Other | 990 Thousand Oaks Dr, Lawrenceville, GA 30043-3123 | 2019-10-14 |
| 1043852197 | James Hoffman | Specialist/Technologist, Other | 1415 Highway 85 N Ste 310-147, Fayetteville, GA 30214-7738 | 2019-10-10 |
| 1851933170 | Andres Eduardo Gomez Vargas | Specialist/Technologist, Other | 965 Dogwood Park Dr, Lawrenceville, GA 30046-9335 | 2019-10-09 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30083 |
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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.