TRENT LORNE PRAULT (NPI# 1992746747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992746747 |
Entity Type | Individual |
Full Name | TRENT LORNE PRAULT |
Credential | MD |
Practice Address |
550 Redmond Rd Nw Rome GA 30165-1416 |
Mailing Address |
221 Technology Pkwy Nw Rome GA 30165-1369 |
Practice Telephone | 7062338508 |
Practice Fax Number | 7062338509 |
Mailing Telephone | 7622351000 |
Enumeration Date | 2006-06-10 |
Last Update Date | 2020-04-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
058103 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 057976876A | 05 |
Street Address |
550 REDMOND RD NW |
City | ROME |
State | GA |
Zip Code | 30165-1416 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457346496 | Poonam Singh | Internal Medicine | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2005-09-15 |
1174158505 | Whitney Tolbert Albright | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2020-03-05 |
1457990020 | Kimberly Mae Evans | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-12-31 |
1710522933 | William Edward Johnson | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-11-12 |
1053876391 | Samantha Danielle Pruitt | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-01-31 |
1205311131 | Austin James Malcom | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2018-09-26 |
1972025955 | Tricia Lee Nelson | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2017-07-12 |
1417400318 | Inga Elita Bennett | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-07-27 |
1306298674 | Krishna Sumeer Tah | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-07-11 |
1467807750 | Robin Ann Hawkland | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-04-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
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Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801958772 | John Smith Kirkland Jr. | Surgery | 796 N Division St Nw, Rome, GA 30165-1404 | 2006-12-15 |
1205128238 | Rome Medical Practice | Surgery | 1617 N James St, Suite 700, Rome, NY 13440-2852 | 2011-05-10 |
1285950055 | Frank Durham Stegall Jr. | Surgery | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2010-04-19 |
1194880351 | Delmar Michael Rogers | Surgery | 796 N Division St Nw, Rome, GA 30165-1404 | 2006-12-27 |
1902968647 | Jonathon Richard Molnar | Surgery | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2006-12-15 |
1619947017 | David Bailey Wilson | Surgery | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2006-01-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
1902423387 | Center for Vein Restoration Ga Corp | Surgery | 1100 Johnson Fy Rd Ne Ste 165, Atlanta, GA 30342-1795 | 2020-07-01 |
1487133278 | Usa Vascular Center of Decatur LLC | Surgery | 495 Winn Way Ste 230, Decatur, GA 30030-1736 | 2018-08-13 |
1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
1689012205 | Daniel Joseph Badia | Surgery | 601 Professional Dr Ste A220, Lawrenceville, GA 30046-7698 | 2013-06-05 |
1740507425 | Christopher Ray Ramos | Surgery | 1365 Clifton Road Ne, Building A, Room A2200, Atlanta, GA 30322 | 2010-04-21 |
1184879678 | Rockdale Vascular and Thoracic Surgery, LLC | Surgery | 1368c Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2008-11-25 |
1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
1487819132 | Yazan Duwayri | Surgery | Division of Vascular Surgery Emory Clinic Bldg A, 1365 Clifton Road Ne. 3rd Floor, Atlanta, GA 30322-0001 | 2008-07-22 |
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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.