Emmanuel Gage (NPI# 1720213093, PAC ID# 0749405702) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL PAIN MANAGEMENT.
| Nation Provider ID (NPI) | 1720213093 |
| PAC ID by PECOS | 0749405702 |
| Professional Enrollment ID | I20141023002596 |
| Full Name | Emmanuel Gage |
| Organization Legal Name | SPINE CENTER OF SOUTHEAST GEORGIA LLC |
| Address |
1111 Glynco Pkwy Suite 300 Brunswick GA 31525-7933 |
| Phone Number | 9122626552107 |
| Gender | M |
| Graduation Year | 2009 |
| Primary Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| Secondary Specialties | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 0143294231 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110146 | SOUTHEAST GEORGIA HEALTH SYSTEM -- CAMDEN CAMPUS |
| 110025 | SOUTHEAST GEORGIA HEALTH SYSTEM- BRUNSWICK CAMPUS |
| 110003 | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS |
| Address | Phone | Organization |
|---|---|---|
| 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 | 9122626552107 | SPINE CENTER OF SOUTHEAST GEORGIA LLC |
| 52 A Lindy Ln, Kingsland, GA 31548-5560 | 9122626552 | SPINE CENTER OF SOUTHEAST GEORGIA LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | SPINE CENTER OF SOUTHEAST GEORGIA LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Rachel Bishop | Physician Assistant | Spine Center of Southeast Georgia LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Christopher J Bovinet | Interventional Pain Management | Spine Center of Southeast Georgia LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Matthew R Boothby | Physician Assistant | Spine Center of Southeast Georgia LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Street Address |
1111 GLYNCO PKWY SUITE 300 |
| City | BRUNSWICK |
| State | GA |
| Zip | 31525-7933 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathon W Capps | Physician Assistant | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| Laura Rachel Bishop | Physician Assistant | Spine Center of Southeast Georgia LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Christopher J Mathews | Family Medicine | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| James C Smith | Nurse Practitioner | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| Jamie N Campbell | Physician Assistant | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| Chevita Fuller | Nurse Practitioner | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| Christopher J Bovinet | Interventional Pain Management | Spine Center of Southeast Georgia LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Caroline Dejarnett Flexer | Nurse Practitioner | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| James Tyler Hawkins | Physician Assistant | Applecare LLC | 1111 Glynco Pkwy, Building A Suite 10, Brunswick, GA 31525-7921 |
| Charles D Daniel | Certified Registered Nurse Anesthetist (crna) | Tranquil Anesthesiology LLC | 1111 Glynco Pkwy, Suite 300, Brunswick, GA 31525-7933 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Melissa Schmidt | Family Medicine | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| David T Boczar | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| Jennifer L Boczar | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| Kathy Louise Munro | Clinical Social Worker | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| Jay William Floyd | Family Medicine | Coastal Community Health Services Inc. | 106 Shoopers Way, Suite 1, Brunswick, GA 31525 |
| Wilbur Eugene Brown | Chiropractic | Family Health Chiropractic | 92 Village At Aglynn Place, Brunswick, GA 31525 |
| John B Mclaulin | Geriatric Psychiatry | 106 Shoppers Way, Suite 115, Brunswick, GA 31525-0522 | |
| Robert E Holland | Psychiatry | 106 Shoppers Way, Suite 115, Brunswick, GA 31525-0522 | |
| Amber L Wellman | Chiropractic | Wellman Family Healthcare | 124 Chapel Crossing Rd, Brunswick, GA 31525-0529 |
| Robert Wellman | Chiropractic | Wellman Family Healthcare | 124 Chapel Crossing Rd, Brunswick, GA 31525-0529 |
| Find all physicians in zip 31525 | |||
| City | BRUNSWICK |
| Zip Code | 31525 |
| Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| City + Specialty | BRUNSWICK + INTERVENTIONAL PAIN MANAGEMENT |
Please comment or provide details below to improve the information on Emmanuel Gage.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.