GUILLERMO GOMEZ (NPI# 1972508752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972508752 |
| Entity Type | Individual |
| Full Name | GUILLERMO GOMEZ |
| Credential | NP |
| Practice Address |
4146 Jonesboro Rd Forest Park GA 30297-1038 |
| Mailing Address |
165 Victoria Dr Ellenwood GA 30294-2854 |
| Practice Telephone | 4043612469 |
| Mailing Telephone | 7705982158 |
| Mailing Fax Number | 4043612427 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2008-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN126015 NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 810457223B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164814091 | Guillermo Gomez Jr. | Nurse Practitioner | 221 N Kansas St Ste 1501, El Paso, TX 79901-1400 | 2015-03-02 |
| 1538137898 | Guillermo Javier Gomez | Family Medicine | 3750 Arlington Ave, Riverside, CA 92506-2607 | 2006-03-10 |
| 1659894673 | Guillermo A Gomez | Obstetrics & Gynecology | 2051 Marengo St, Los Angeles, CA 90033-1352 | 2017-07-21 |
| 1619401924 | Guillermo Antonio Gomez Jr. | Social Worker | 1825 Nw 167th St, Suit 102, Miami Gardens, FL 33056-4838 | 2017-04-13 |
| 1396142527 | Guillermo Gomez | Acupuncturist | 1630 Oakland Rd, Suite #a110, San Jose, CA 95131-2449 | 2014-12-03 |
| 1902054505 | Guillermo Gomez Jr. | Counselor | 1790 N Lee Trevino Dr, El Paso, TX 79936-4545 | 2008-09-08 |
| 1245391978 | Guillermo Gomez | Dentist | 7036 Antoine Dr, Houston, TX 77088-6613 | 2006-12-13 |
| 1174623318 | Guillermo A Gomez | Surgery | 301 University Blvd, Galveston, TX 77555-5302 | 2006-09-25 |
| Street Address |
4146 JONESBORO RD |
| City | FOREST PARK |
| State | GA |
| Zip Code | 30297-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093977381 | Joseph S Leyva | General Practice | 4146 Jonesboro Rd, Forest Park, GA 30297-1038 | 2008-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548747173 | Ga Peach Medical Transportation, LLC | Ambulance | 5023 Highway 85, Forest Park, GA 30297 | 2018-07-26 |
| 1871940437 | Crystal Harrison | Counselor | 4659 Ruby Ln, Forest Park, GA 30297 | 2016-05-24 |
| 1467807156 | Naundria Jackson | Nurse Practitioner | Apmc, Forest Park, GA 30297 | 2016-04-29 |
| 1891156089 | Gentle Care Medical Trans LLC | Ambulance | 530 Forest Parkway Suite B, Forest Park, GA 30297 | 2016-03-15 |
| 1811318835 | Kim Mckinney | Case Manager/Care Coordinator | 1104 South Parkwood Drive, Forest Park, GA 30297 | 2013-12-17 |
| 1215361910 | Tiffany Nadine Adams | Specialist | 228 Morrow Rd 18h, Forest Park, GA 30297 | 2013-08-29 |
| 1851663124 | Daffodil Pediatrics and Family Medicine | Pediatrics | 4905 Courtney Drive, Forest Park, GA 30297 | 2012-02-02 |
| 1093093759 | Truliant Health Systems | Community/Behavioral Health | 526 Forest Parkway Ste D, Forest Park, GA 30297 | 2011-07-29 |
| 1811134133 | Sharonda Renee Forte | Orthopaedic Surgery | 4940 Governors Park Drive, Forest Park, GA 30297 | 2009-01-08 |
| 1215173737 | Comfort Personal Care Service | Assisted Living Facility | 5530 Old Dixie Highway, D-9, Forest Park, GA 30297 | 2009-01-06 |
| Find all providers in zip 30297 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548817208 | Arlene Santiago-sutton | Nurse Practitioner | 455 Forest Pkwy, Forest Park, GA 30297-2126 | 2019-08-19 |
| 1467807156 | Naundria Jackson | Nurse Practitioner | Apmc, Forest Park, GA 30297 | 2016-04-29 |
| 1841516630 | Charles Jenkins IIi | Nurse Practitioner | 4390 Governors Drive, Suite 409, Forest Park, GA 30297-6101 | 2010-04-19 |
| 1407091705 | Clinica Agave Clinic | Nurse Practitioner | 4434 Jonesboro Rd, Forest Park, GA 30297-4313 | 2008-12-16 |
| 1477054260 | Diana Carmichael | Nurse Practitioner | 528 Forest Pkwy Ste A, Forest Park, GA 30297-6109 | 2018-02-27 |
| 1487181061 | Arleen Revely | Nurse Practitioner | 528 Forest Pkwy Ste A, Forest Park, GA 30297-6109 | 2017-05-15 |
| 1871969469 | Lisa Roseberry | Nurse Practitioner | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2015-08-18 |
| 1174916621 | Antoinette Denise Palomino | Nurse Practitioner | 4905 Courtney Dr, Forest Park, GA 30297-1427 | 2015-03-09 |
| 1750661112 | Christine Johnson | Nurse Practitioner | 8311 Roosevelt Rd, Forest Park, IL 60130-2529 | 2011-08-17 |
| 1659681963 | Sandra Martell | Nurse Practitioner | 7556 Jackson Blvd, Forest Park, IL 60130-1854 | 2010-10-20 |
| Find all providers in FOREST PARK | ||||
| City | FOREST PARK |
| Zip Code | 30297 |
Please comment or provide details below to improve the information on GUILLERMO GOMEZ.
| 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.