| Augusta Primary Care Services Llc | |
|
3624 J Dewey Gray Cir Suite 308 Augusta GA 30909-6584 | |
| (706) 855-5650 | |
| (706) 863-0821 |
| Full Name | Augusta Primary Care Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3624 J Dewey Gray Cir, Augusta, Georgia |
| Authorized Official Name and Position | Robert Faile (VICE PRESIDENT) |
| Authorized Official Contact | 8438567923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Augusta Primary Care Services Llc 3624 J Dewey Gray Cir Suite 308 Augusta GA 30909-6584 Ph: (706) 855-5650 | Augusta Primary Care Services Llc 3624 J Dewey Gray Cir Suite 308 Augusta GA 30909-6584 Ph: (706) 855-5650 |
| NPI Number | 1952565210 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 10/17/2017 |
| Medicare PECOS PAC ID | 2466513874 |
|---|---|
| Medicare Enrollment ID | O20090126000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952565210 | NPI | - | NPPES |
| 298706473A | Medicaid | GA | |
| GP5358 | Medicaid | SC | |
| 298706473B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bhagat K Reddy |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144225293 PECOS PAC ID: 1850367558 Enrollment ID: I20040903000500 |
| Provider Name | Wilder G Little |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033214259 PECOS PAC ID: 7911953401 Enrollment ID: I20050328001001 |
| Provider Name | Robert Coronna Abramson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871545590 PECOS PAC ID: 9032022330 Enrollment ID: I20050712000504 |
| Provider Name | Sunil K Lal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952320236 PECOS PAC ID: 5395748297 Enrollment ID: I20060815000173 |
| Provider Name | William Jeffrey Rosenblum |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376643031 PECOS PAC ID: 4284737214 Enrollment ID: I20080520000600 |
| Provider Name | Dominic R Gallo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1891803821 PECOS PAC ID: 3678611019 Enrollment ID: I20091105000215 |
| Provider Name | Michael William Blaney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992881122 PECOS PAC ID: 7618985110 Enrollment ID: I20101215000928 |
| Provider Name | Jonathan Nwiloh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194782011 PECOS PAC ID: 1254244932 Enrollment ID: I20110131000249 |
| Provider Name | Thomas Edward Dykes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710069034 PECOS PAC ID: 3476734252 Enrollment ID: I20110228000245 |
| Provider Name | Mark D Keesling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871871525 PECOS PAC ID: 4183894512 Enrollment ID: I20110823000325 |
| Provider Name | Francisco J Jacome |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316128432 PECOS PAC ID: 0042464893 Enrollment ID: I20130204000329 |
| Provider Name | Rodolfo Rozindo Machado |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124235536 PECOS PAC ID: 4587804513 Enrollment ID: I20130715000707 |
| Provider Name | Christopher S Hogan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932220233 PECOS PAC ID: 3779731435 Enrollment ID: I20140325001322 |
| Provider Name | Phyllis P Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487081261 PECOS PAC ID: 9638302706 Enrollment ID: I20140428000139 |
| Provider Name | Mary E Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184047565 PECOS PAC ID: 3577787829 Enrollment ID: I20140606001858 |
| Provider Name | Jeanne Ann Haid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447512710 PECOS PAC ID: 9234457003 Enrollment ID: I20150408001164 |
| Provider Name | Sean Javaheri |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982677605 PECOS PAC ID: 9830313410 Enrollment ID: I20150422001093 |
| Provider Name | Courtney K Pettiford |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770700163 PECOS PAC ID: 1850563933 Enrollment ID: I20151207001376 |
| Provider Name | Jacquelyn Kalv |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568848109 PECOS PAC ID: 7911204441 Enrollment ID: I20160329002096 |
| Provider Name | James Bardoner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558652032 PECOS PAC ID: 7517259658 Enrollment ID: I20160708002222 |
| Provider Name | Michael B Monahan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114213428 PECOS PAC ID: 9234421066 Enrollment ID: I20160714000911 |
| Provider Name | Linda Marie Street |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962630830 PECOS PAC ID: 1153579735 Enrollment ID: I20160726003081 |
| Provider Name | Jose Miguel Iturbe |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174753198 PECOS PAC ID: 2961782198 Enrollment ID: I20161206000540 |
| Provider Name | John Keeley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316164288 PECOS PAC ID: 8527208719 Enrollment ID: I20170214000772 |
| Provider Name | Robert Douglas Rice |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1841461027 PECOS PAC ID: 3274818570 Enrollment ID: I20170329001791 |
| Provider Name | Cynthia A Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295291862 PECOS PAC ID: 8527300979 Enrollment ID: I20190503001972 |
| Provider Name | Sophia D Goodridge |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255690905 PECOS PAC ID: 6709166440 Enrollment ID: I20190719000894 |
| Provider Name | Jody Christopher Criswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346893161 PECOS PAC ID: 2769713312 Enrollment ID: I20191011001323 |
| Provider Name | William N Kantor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851441828 PECOS PAC ID: 6608942495 Enrollment ID: I20200504002517 |
| Provider Name | Mohammed Almzayyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013350131 PECOS PAC ID: 9133433840 Enrollment ID: I20200806002152 |
| Provider Name | Douglas T Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912511064 PECOS PAC ID: 1658781414 Enrollment ID: I20201105001771 |
| Provider Name | Robert Blackwelder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558993576 PECOS PAC ID: 7911312426 Enrollment ID: I20210216000563 |
| Provider Name | Arthur Robert Johnson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730599770 PECOS PAC ID: 0143444984 Enrollment ID: I20211004001770 |
| Provider Name | Faiz Ur Rehman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518304534 PECOS PAC ID: 5890027882 Enrollment ID: I20211228001990 |
| Provider Name | Vijay Patel |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1922108976 PECOS PAC ID: 0547229197 Enrollment ID: I20220309002198 |
| Provider Name | Laura Margaret Mcelveen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891428421 PECOS PAC ID: 3072981497 Enrollment ID: I20221116000982 |
| Provider Name | Patrick Doyle Leidig |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659768158 PECOS PAC ID: 1658664248 Enrollment ID: I20230105002595 |
| Provider Name | Benjamin Muller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033573514 PECOS PAC ID: 8921420506 Enrollment ID: I20230823000288 |
| Provider Name | Alyssa Imperatore Ziehm |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134657760 PECOS PAC ID: 2769845445 Enrollment ID: I20230829000436 |
| Provider Name | Dustie Michelle Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477336832 PECOS PAC ID: 8820452014 Enrollment ID: I20230906002355 |
| Provider Name | Lynda Nicole Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710472121 PECOS PAC ID: 1456600642 Enrollment ID: I20231102001633 |
| Provider Name | Brynn E Gibbons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700585999 PECOS PAC ID: 1456708585 Enrollment ID: I20231113000618 |
Infectious Disease Consultants Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 St. Sebastian Way, Suite 4a, Augusta, GA 30901 Phone: 706-724-4376 Fax: 706-731-5289 | |
Augusta Hypertention, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1021 15th St Ste 2, Bio Tech Park, Augusta, GA 30901 Phone: 706-722-4688 Fax: 706-722-8194 | |
Welcome Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 Davis Rd Ste 4a, Augusta, GA 30907 Phone: 706-504-9321 | |
Reba Brown Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Pleasant Home Rd Ste A, Augusta, GA 30907 Phone: 706-364-7398 | |
Benjamin L. Rucker M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1138 Druid Park Ave, Suite B, Augusta, GA 30904 Phone: 706-733-9447 Fax: 706-738-0863 | |
Neighborhood Improvement Project Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2300 Wrightsboro Rd, Augusta, GA 30904 Phone: 706-790-4440 | |
Champion Orthopedics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1706 Magnolia Way, Augusta, GA 30909 Phone: 706-210-7529 Fax: 706-312-7610 |