Allen Lavender Jr. (NPI# 1124339478, PAC ID# 7810123288) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1124339478 |
| PAC ID by PECOS | 7810123288 |
| Professional Enrollment ID | I20141202000766 |
| Full Name | Allen Lavender Jr. |
| Organization Legal Name | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| Address |
756 Woodbury Rd Greenville GA 30222-1514 |
| Phone Number | 7066721118 |
| Gender | M |
| Medical School | KANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS |
| Graduation Year | 2010 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 5193712073 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110229 | PIEDMONT NEWNAN HOSPITAL, INC |
| Address | Phone | Organization |
|---|---|---|
| 756 Woodbury Rd, Greenville, GA 30222-1514 | 7066721118 | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| 122 Gordon Commercial Dr C, Lagrange, GA 30240-5754 | 7068454045 | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| 122 Gordon Commercial Dr D, Lagrange, GA 30240-5754 | 7068454054 | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| 124 Gordon Commercial Dr, Lagrange, GA 30240-5740 | 7068454065 | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| Organization Legal Name | PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linda Joy Knight- Nelson | Psychiatry | Pathways Center for Behavioral and Developmental Growth | 153 Independence Dr, Carrollton, GA 30116-9000 |
| Debora S Johnson | Psychiatry | Pathways Center for Behavioral and Developmental Growth | 122 Gordon Commercial Dr C, Lagrange, GA 30240-5754 |
| Amber N Tidwell | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 1206 Franklin Pkwy, Franklin, GA 30217-7508 |
| Donald Manning | Psychiatry | Pathways Center for Behavioral and Developmental Growth | 124 Gordon Commercial Dr, Lagrange, GA 30240-5740 |
| Franchon R Scales | Physician Assistant | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Nicole D Knight | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Ranga P Rao | Psychiatry | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Rugiatu Bahr | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Lauren E Hornsby | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 124 Gordon Commercial Dr, Lagrange, GA 30240-5740 |
| Kalene Mcswain-faulkner | Clinical Social Worker | Pathways Center for Behavioral and Developmental Growth | 1206 Franklin Pkwy, Franklin, GA 30217-7508 |
| Street Address |
756 WOODBURY RD |
| City | GREENVILLE |
| State | GA |
| Zip | 30222-1514 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Franchon R Scales | Physician Assistant | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Nicole D Knight | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Ranga P Rao | Psychiatry | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Rugiatu Bahr | Nurse Practitioner | Pathways Center for Behavioral and Developmental Growth | 756 Woodbury Rd, Greenville, GA 30222-1514 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martha D Clements | General Practice | Wellstar Medical Group, LLC | 454 Lagrange St, Greenville, GA 30222-1303 |
| Mack H Clements | Family Medicine | Wellstar Medical Group, LLC | 454 Lagrange St, Greenville, GA 30222-1303 |
| Patricia C Ubani-ebere | Internal Medicine | 7007 C Williams St, Greenville, GA 30222-1354 |
| City | GREENVILLE |
| Zip Code | 30222 |
| Specialty | PSYCHIATRY |
| City + Specialty | GREENVILLE + PSYCHIATRY |
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| 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.