Nicole Tabatha Rivera (NPI# 1205002151, PAC ID# 4486724895) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1205002151 |
| PAC ID by PECOS | 4486724895 |
| Professional Enrollment ID | I20080528000237 |
| Full Name | Nicole Tabatha Rivera |
| Organization Legal Name | AGA PROFESSIONAL SERVICES LLC |
| Address |
900 Towne Lake Pkwy Suite 308 Woodstock GA 30189-1604 |
| Phone Number | 7709265459 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3870768997 |
| Number of Group Practice Members | 116 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110008 | NORTHSIDE HOSPITAL CHEROKEE |
| 110161 | NORTHSIDE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2401 Newnan Crossing Blvd, Suite 110, Newnan, GA 30265-2408 | 6786314610 | AGA PROFESSIONAL SERVICES LLC |
| 900 Towne Lake Pkwy, Suite 308, Woodstock, GA 30189-1604 | 7709265459 | AGA PROFESSIONAL SERVICES LLC |
| Organization Legal Name | AGA PROFESSIONAL SERVICES LLC |
| Physicians | 43 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Lynn Azelton | Nurse Practitioner | Aga Professional Services LLC | 226 E College St, Suite B, Griffin, GA 30224-4348 |
| Susan Danielle Beitzell | Nurse Practitioner | Aga Professional Services LLC | 340 N Milledge Ave, Suite B, Athens, GA 30601-3806 |
| Heather Rose Van Duys | Physician Assistant | Aga Professional Services LLC | 2401 Newnan Crossing Blvd, Suite 110, Newnan, GA 30265-2408 |
| Shontreka A Glover | Nurse Practitioner | Aga Professional Services LLC | 34 Upper Riverdale Rd Se, Suite 201, Riverdale, GA 30274-2635 |
| Chundra Brooks | Nurse Practitioner | Aga Professional Services LLC | 301 Phillip Blvd, Suite A, Lawrenceville, GA 30046 |
| Tracy J Herring | Nurse Practitioner | Aga Professional Services LLC | 2020 Cumming Hwy, Suite 102, Canton, GA 30115-8071 |
| Jaime G Ackerman | Physician Assistant | Aga Professional Services LLC | 488 Kennesaw Ave, Marietta, GA 30060-9409 |
| Melissa B Baughcum | Nurse Practitioner | Aga Professional Services LLC | 2401 Newnan Crossing Blvd, Suite 110, Newnan, GA 30265-2408 |
| Rayllensons Itacy | Physician Assistant | Aga Professional Services LLC | 2401 Newnan Crossing Blvd, Suite 110, Newnan, GA 30265-2408 |
| Aakashi D Patel | Physician Assistant | Aga Professional Services LLC | 2401 Newnan Crossing Blvd, Suite 110, Newnan, GA 30265-2408 |
| Street Address |
900 TOWNE LAKE PKWY SUITE 308 |
| City | WOODSTOCK |
| State | GA |
| Zip | 30189-1604 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Grant C Wolfe | General Surgery | Northside Surgical Professional Services LLC | 900 Towne Lake Pkwy, Suite 412, Woodstock, GA 30189-1604 |
| Reagan O'connor | Nurse Practitioner | Physician's Express Care At Towne Lake LLC | 900 Towne Lake Pkwy, Suite 104, Woodstock, GA 30189-1603 |
| Cesar Cruz Aguilar | Cardiac Electrophysiology | Northside Cardiovascular Professional Services,llc | 900 Towne Lake Pkwy, Suite 400, Woodstock, GA 30189-1604 |
| Anand Shantha | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| James M Elmore | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Andrew J Kirsch | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Beniam Tefera Abebe | Physician Assistant | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Robert S Kaufmann | Internal Medicine | The Kaufmann Clinic Inc | 900 Towne Lake Pkwy, Suite 300, Woodstock, GA 30189-1604 |
| Adamantios Michael Mellis | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Eden Y Shapiro | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lili D Gipson | Chiropractic | 715 A Bascomb Comm Pkwy, Woodstock, GA 30189 | |
| Carrie E Tyner | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Paula S Thibault | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Naomi S Morson | Nurse Practitioner | Minute Clinic LLC | 1600 Towne Lake Pkwy, Woodstock, GA 30189-1585 |
| Victoria M Wermers | Nurse Practitioner | Piedmont Professional Services, LLC | 950 Towne Lake Pkwy, Woodstock, GA 30189-1601 |
| Safiah Vafaeian | Nurse Practitioner | Piedmont Professional Services, LLC | 950 Towne Lake Pkwy, Woodstock, GA 30189-1601 |
| Fernando A Duralde | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Graham B Matthews | Family Medicine | Perimeter Professional Services, LLC | 900 Towne Lake Pkwy, Suite 210, Woodstock, GA 30189-1603 |
| Emily Ussery | Nurse Practitioner | Physician's Express Care At Towne Lake LLC | 900 Towne Lake Pkwy, Suite 104, Woodstock, GA 30189-1603 |
| Darrell J Carmen | Urology | Georgia Urology, Pa | 900 Towne Lake Pkwy, Suite 200, Woodstock, GA 30189-1603 |
| Find all physicians in zip 30189 | |||
| City | WOODSTOCK |
| Zip Code | 30189 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | WOODSTOCK + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Nicole Tabatha Rivera.
| 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.