| Renuven Health Partners Of Georgia Pc | |
|
2403 Battlefield Pkwy Fort Oglethorpe GA 30742-4033 | |
| (423) 979-5804 | |
| Not Available |
| Full Name | Renuven Health Partners Of Georgia Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2403 Battlefield Pkwy, Fort Oglethorpe, Georgia |
| Authorized Official Name and Position | Bert J. Smith (CEO) |
| Authorized Official Contact | 4239262358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renuven Health Partners Of Georgia Pc 2717 E Oakland Ave Johnson City TN 37601-1843 Ph: (423) 926-2358 | Renuven Health Partners Of Georgia Pc 2403 Battlefield Pkwy Fort Oglethorpe GA 30742-4033 Ph: (423) 979-5804 |
| NPI Number | 1871196519 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 09/17/2025 |
| Medicare PECOS PAC ID | 5890107171 |
|---|---|
| Medicare Enrollment ID | O20201210000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871196519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James A Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184602898 PECOS PAC ID: 0547230096 Enrollment ID: I20040914000203 |
| Provider Name | Sherri Nation |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396137899 PECOS PAC ID: 3375861461 Enrollment ID: I20151208001039 |
| Provider Name | Don E Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245215847 PECOS PAC ID: 6709866817 Enrollment ID: I20201210002219 |
| Provider Name | Bert J Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497839070 PECOS PAC ID: 4587738877 Enrollment ID: I20210104001118 |
| Provider Name | Nicholas J Dieringer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124003561 PECOS PAC ID: 1850375981 Enrollment ID: I20210816003901 |
| Provider Name | Angela H Sullivan-bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063405553 PECOS PAC ID: 6608776927 Enrollment ID: I20220705001752 |
| Provider Name | Kathleen J Locker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578698270 PECOS PAC ID: 4082696968 Enrollment ID: I20220926001241 |
| Provider Name | Celeste Harnden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316235997 PECOS PAC ID: 5092957712 Enrollment ID: I20231101000564 |
| Provider Name | Joselyn Ghulam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992137277 PECOS PAC ID: 5799005351 Enrollment ID: I20250226003789 |
| Provider Name | Galina Rader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932138658 PECOS PAC ID: 1658314315 Enrollment ID: I20250321003077 |
| Provider Name | Cristy Rickita Mccrobey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003616459 PECOS PAC ID: 2365961133 Enrollment ID: I20250529001617 |
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