Tina L. Hathaway (NPI# 1023529914, PAC ID# 1355604174) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1023529914 |
| PAC ID by PECOS | 1355604174 |
| Professional Enrollment ID | I20180409002444 |
| Full Name | Tina L. Hathaway |
| Organization Legal Name | EAST GEORGIA HMA PHYSICIAN MANAGEMENT LLC |
| Address |
1497 Fair Rd Statesboro GA 30458-0823 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7214068592 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110075 | EAST GEORGIA REGIONAL MEDICAL CENTER |
| 110142 | EVANS MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 114 Hill Pond Ln, Statesboro, GA 30458-0872 | 9126816944 | EAST GEORGIA HMA PHYSICIAN MANAGEMENT LLC |
| 1497 Fair Rd, Statesboro, GA 30458-0823 | EAST GEORGIA HMA PHYSICIAN MANAGEMENT LLC |
| Organization Legal Name | EAST GEORGIA HMA PHYSICIAN MANAGEMENT LLC |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark P Crick | Internal Medicine | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Akram Mahmoud Hassanyeh | General Surgery | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Robert M Benson | Family Medicine | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Justin Lee Rountree | Anesthesiology | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Karri O Ray | Physician Assistant | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Jessica Bradshaw Reinhardt | Nurse Practitioner | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Kathryn Hilovsky Janufka | Physician Assistant | East Georgia Hma Physician Management LLC | 400 Cedar St, Metter, GA 30439-3338 |
| Tiffany B Kreun | Nurse Practitioner | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Jeanna Lynn Smith | Nurse Practitioner | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Kenneth Brian Walton | General Surgery | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Street Address |
1497 FAIR RD |
| City | STATESBORO |
| State | GA |
| Zip | 30458-0823 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark P Crick | Internal Medicine | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Akram Mahmoud Hassanyeh | General Surgery | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Robert M Benson | Family Medicine | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Justin Lee Rountree | Anesthesiology | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Ajay Jain | Cardiovascular Disease (cardiology) | Cardiovascular Associates of Eastern Georgia | 1497 Fair Rd, Suite 305, Statesboro, GA 30458-0828 |
| Karri O Ray | Physician Assistant | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| John E Martin | General Surgery | 1497 Fair Rd, Suite 103, Statesboro, GA 30458-0823 | |
| Jessica Bradshaw Reinhardt | Nurse Practitioner | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Statesboro, GA 30458-0823 |
| Ruth Ann Mazo | Urology | Urological Associates of Savannah, PC | 1497 Fair Rd, Suite 204, Statesboro, GA 30458-0824 |
| Tiffany B Kreun | Nurse Practitioner | East Georgia Hma Physician Management LLC | 1497 Fair Rd, Suite 102, Statesboro, GA 30458-0823 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy O Kitching | Chiropractic | 2 Ed Moore Court, Statesboro, GA 30458 | |
| Samuel D Chapman | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Karen C Penrose | Nurse Practitioner | Sidney P Smith Md PC | 6677 Ga Hwy 67, Statesboro, GA 30458 |
| Elizabeth Hinely | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Andrea B Pitts | Nurse Practitioner | The Neurological Institute of Savannah and Center for Spine P C | 1213 Merchants Way, Unit A, Statesboro, GA 30458 |
| Anuj Goel | Psychiatry | Dps Health and Wellness | 204 S Main St, Statesboro, GA 30458-0723 |
| Deborah Stewart | Nurse Practitioner | Dps Health and Wellness | 204 S Main St, Statesboro, GA 30458-0723 |
| Saraju C Dalsania | Internal Medicine | 1601 Fair Rd, Suite 700, Statesboro, GA 30458-0800 | |
| Stacey C Basquin | Physician Assistant | East Georgia Hma Physician Management LLC | 1601 Fair Rd, Suite 600, Statesboro, GA 30458-0800 |
| Harsh Bhushan | Hematology/oncology | 1601 Fair Rd, Suite 900, Statesboro, GA 30458-0800 | |
| Find all physicians in zip 30458 | |||
| City | STATESBORO |
| Zip Code | 30458 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | STATESBORO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Tina L. Hathaway.
| 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.