| The Longstreet Clinic, Pc | |
|
725 Jesse Jewell Pkwy Se Gainesville GA 30501-3834 | |
| (770) 718-1122 | |
| (770) 533-4786 |
| Full Name | The Longstreet Clinic, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 725 Jesse Jewell Pkwy Se, Gainesville, Georgia |
| Authorized Official Name and Position | Amelia Lowe Collins (CEO) |
| Authorized Official Contact | 7707181122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Longstreet Clinic, Pc Po Box 658 Gainesville GA 30503-0658 Ph: (770) 718-1122 | The Longstreet Clinic, Pc 725 Jesse Jewell Pkwy Se Gainesville GA 30501-3834 Ph: (770) 718-1122 |
| NPI Number | 1326019977 |
|---|---|
| Provider Enumeration Date | 01/31/2006 |
| Last Update Date | 05/27/2021 |
| Medicare PECOS PAC ID | 2668465733 |
|---|---|
| Medicare Enrollment ID | O20040405001521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326019977 | NPI | - | NPPES |
| Provider Name | Barry G Munn |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609882034 PECOS PAC ID: 3476540345 Enrollment ID: I20040430000780 |
| Provider Name | Derek R Moore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871516930 PECOS PAC ID: 9234117417 Enrollment ID: I20040713000914 |
| Provider Name | Chandra Marea Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124098140 PECOS PAC ID: 2466424858 Enrollment ID: I20040806000799 |
| Provider Name | Katherine Powe Deavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760466783 PECOS PAC ID: 2668441023 Enrollment ID: I20041001000338 |
| Provider Name | David L Kimball |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114976461 PECOS PAC ID: 5597726869 Enrollment ID: I20041020000565 |
| Provider Name | Margaret A Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811989411 PECOS PAC ID: 9638136294 Enrollment ID: I20041215000260 |
| Provider Name | Melissa L West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457323487 PECOS PAC ID: 1456318039 Enrollment ID: I20041215000452 |
| Provider Name | Mujtaba S Sheikh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770685547 PECOS PAC ID: 7517907413 Enrollment ID: I20050510001007 |
| Provider Name | Jason T Snyder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235164724 PECOS PAC ID: 0143284521 Enrollment ID: I20050520000088 |
| Provider Name | Christopher A Hulsey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205822533 PECOS PAC ID: 2062440340 Enrollment ID: I20050728000361 |
| Provider Name | Chad Copper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205816212 PECOS PAC ID: 0840229860 Enrollment ID: I20050810000714 |
| Provider Name | William R Weaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679557805 PECOS PAC ID: 9638104615 Enrollment ID: I20050928000775 |
| Provider Name | Charles Bruce Moomey |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689671364 PECOS PAC ID: 4981622487 Enrollment ID: I20051109000841 |
| Provider Name | Lajos Toth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306816467 PECOS PAC ID: 4183645419 Enrollment ID: I20051214000167 |
| Provider Name | Michael J Mulberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386696268 PECOS PAC ID: 4981627635 Enrollment ID: I20060109000290 |
| Provider Name | Marti R Gibbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083694905 PECOS PAC ID: 7618984022 Enrollment ID: I20060309000457 |
| Provider Name | Andrew B Reisman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053391490 PECOS PAC ID: 1052328465 Enrollment ID: I20060309000477 |
| Provider Name | Cynthia A Cabrera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023097227 PECOS PAC ID: 0749298107 Enrollment ID: I20060327000247 |
| Provider Name | Joseph B Gunn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609846369 PECOS PAC ID: 6103835921 Enrollment ID: I20060406000099 |
| Provider Name | Andreas Schilling |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033139050 PECOS PAC ID: 5092789610 Enrollment ID: I20060818000049 |
| Provider Name | Mathew J Dixon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871548529 PECOS PAC ID: 1951332451 Enrollment ID: I20060821000329 |
| Provider Name | Cary S Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710919451 PECOS PAC ID: 3678577822 Enrollment ID: I20060831000264 |
| Provider Name | Keshma Saujani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972569119 PECOS PAC ID: 1052353513 Enrollment ID: I20061101000144 |
| Provider Name | Alexander D Allaire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669578282 PECOS PAC ID: 1557369295 Enrollment ID: I20061113000530 |
| Provider Name | Ling Qin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790859536 PECOS PAC ID: 6901806850 Enrollment ID: I20061228000171 |
| Provider Name | Marsha A Stringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659449924 PECOS PAC ID: 9436159829 Enrollment ID: I20070109000352 |
| Provider Name | Caro L Garlich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144375106 PECOS PAC ID: 9638104870 Enrollment ID: I20070322000236 |
| Provider Name | Timothy M Carey |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174725345 PECOS PAC ID: 2769582089 Enrollment ID: I20070716000099 |
| Provider Name | Sherry A Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184820128 PECOS PAC ID: 4981798147 Enrollment ID: I20070919000041 |
| Provider Name | Holly Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740268101 PECOS PAC ID: 2163504812 Enrollment ID: I20080204000014 |
| Provider Name | Celina D Carruth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942284120 PECOS PAC ID: 0749364909 Enrollment ID: I20080226000803 |
| Provider Name | Laurie Staub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790730042 PECOS PAC ID: 7618052358 Enrollment ID: I20080305000633 |
| Provider Name | Amanda T Driskell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104026830 PECOS PAC ID: 2567540347 Enrollment ID: I20080418000376 |
| Provider Name | Garrick K Bailey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104806009 PECOS PAC ID: 4587743885 Enrollment ID: I20080512000040 |
| Provider Name | Rachel A Crudgington |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184746158 PECOS PAC ID: 0244300630 Enrollment ID: I20080528000014 |
| Provider Name | Megan J Farley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083605554 PECOS PAC ID: 8022188416 Enrollment ID: I20080528000040 |
| Provider Name | Daniel A Mullis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245202035 PECOS PAC ID: 8325014640 Enrollment ID: I20080602000571 |
| Provider Name | Angela A Simmons Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124285432 PECOS PAC ID: 3577634385 Enrollment ID: I20080623000477 |
| Provider Name | Jennifer M Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881841047 PECOS PAC ID: 8224106588 Enrollment ID: I20081014000357 |
| Provider Name | Rodney Smith |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144290917 PECOS PAC ID: 2062500887 Enrollment ID: I20081025000151 |
| Provider Name | Paige E Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245392695 PECOS PAC ID: 4880753037 Enrollment ID: I20081104000058 |
| Provider Name | Howard K Aldridge |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740250414 PECOS PAC ID: 7618032467 Enrollment ID: I20090211000751 |
| Provider Name | Laura F Putnam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013997444 PECOS PAC ID: 5799839668 Enrollment ID: I20090812000667 |
| Provider Name | Heather J Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316981335 PECOS PAC ID: 6800932500 Enrollment ID: I20091012000052 |
| Provider Name | Kimberly P Blasingame |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184662280 PECOS PAC ID: 1951445949 Enrollment ID: I20100215000039 |
| Provider Name | Kommerina Daling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730365784 PECOS PAC ID: 4789719873 Enrollment ID: I20100315000489 |
| Provider Name | Kelli N Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104070457 PECOS PAC ID: 2264567783 Enrollment ID: I20100322000815 |
| Provider Name | Karl D Schultz |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558344507 PECOS PAC ID: 9335163351 Enrollment ID: I20100330000392 |
| Provider Name | Crystal Barcenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356672034 PECOS PAC ID: 9436286952 Enrollment ID: I20100414000821 |
| Provider Name | Robert Lawrence Richard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114938172 PECOS PAC ID: 6901936079 Enrollment ID: I20100616000514 |
| Provider Name | Peter Romano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215010384 PECOS PAC ID: 9234202581 Enrollment ID: I20100618000218 |
| Provider Name | Richard Russell Shelton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619947769 PECOS PAC ID: 7214060805 Enrollment ID: I20100803000744 |
| Provider Name | Karin Dipietro Dillard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659351906 PECOS PAC ID: 4688707292 Enrollment ID: I20100803001010 |
| Provider Name | Zachariah Barnard Dillard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346220258 PECOS PAC ID: 7810021003 Enrollment ID: I20100810000240 |
| Provider Name | Fatimah Manzoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750502357 PECOS PAC ID: 8921132952 Enrollment ID: I20100812000945 |
| Provider Name | Eileen Dalmacio Javellana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003896952 PECOS PAC ID: 7517925761 Enrollment ID: I20100827000819 |
| Provider Name | Jocelyne Saweris Tadros |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407000821 PECOS PAC ID: 3173647799 Enrollment ID: I20100902000449 |
| Provider Name | Derek Paul Pendarvis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104806108 PECOS PAC ID: 2466578935 Enrollment ID: I20100922000642 |
| Provider Name | Kelly Michelle Wood |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669576252 PECOS PAC ID: 0446442297 Enrollment ID: I20101012000377 |
| Provider Name | Robert B Barger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699754887 PECOS PAC ID: 0345432019 Enrollment ID: I20101013000625 |
| Provider Name | Jessica A Kobleur |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790982361 PECOS PAC ID: 2365635729 Enrollment ID: I20101019000528 |
| Provider Name | John Francis Mcguire |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427094853 PECOS PAC ID: 7517150576 Enrollment ID: I20101022000106 |
| Provider Name | Rebecca Suzanne Jackson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679516173 PECOS PAC ID: 9032305644 Enrollment ID: I20101122000869 |
| Provider Name | Brett C Baudin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871550988 PECOS PAC ID: 1153596564 Enrollment ID: I20111214000265 |
| Provider Name | Shrena Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811164031 PECOS PAC ID: 4789720335 Enrollment ID: I20120109000783 |
| Provider Name | Kathryn L Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629345798 PECOS PAC ID: 6608033220 Enrollment ID: I20120208000855 |
| Provider Name | Shawn William Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619222528 PECOS PAC ID: 5698921443 Enrollment ID: I20120809000483 |
| Provider Name | Geary D Bush |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447437082 PECOS PAC ID: 1153570254 Enrollment ID: I20121005000001 |
| Provider Name | Wendy Lynn Coto-puckett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316123557 PECOS PAC ID: 2961652599 Enrollment ID: I20121017000348 |
| Provider Name | Diana Julia Calano |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1477828622 PECOS PAC ID: 4981855897 Enrollment ID: I20121126000559 |
| Provider Name | Erum Farooqi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235391533 PECOS PAC ID: 8729258942 Enrollment ID: I20130114000139 |
| Provider Name | Karen Jeanette Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801146402 PECOS PAC ID: 3274772355 Enrollment ID: I20130621000041 |
| Provider Name | Betsy Hughes Grunch |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1265606644 PECOS PAC ID: 4587803671 Enrollment ID: I20130621000109 |
| Provider Name | Ramanpreet Kaur Dhindsa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467773200 PECOS PAC ID: 3971759853 Enrollment ID: I20130716000313 |
| Provider Name | Elizabeth Bernice Coleman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1881033124 PECOS PAC ID: 8921240987 Enrollment ID: I20130805000432 |
| Provider Name | Richard B Allen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407801210 PECOS PAC ID: 8921066655 Enrollment ID: I20130806000129 |
| Provider Name | Lisa Clair Parker Logue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477994804 PECOS PAC ID: 9032352851 Enrollment ID: I20130827000349 |
| Provider Name | Curtis David Malcom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770800377 PECOS PAC ID: 6507090990 Enrollment ID: I20131018001109 |
| Provider Name | Shana B Deloach |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1609218601 PECOS PAC ID: 5496980757 Enrollment ID: I20131023000846 |
| Provider Name | Danny Shane Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083046528 PECOS PAC ID: 7810129731 Enrollment ID: I20140408001467 |
| Provider Name | Diane Arlene Doherty-chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073730032 PECOS PAC ID: 4880827724 Enrollment ID: I20140430001612 |
| Provider Name | Crystal Ann Terrill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124349964 PECOS PAC ID: 6103072418 Enrollment ID: I20140616001011 |
| Provider Name | Jennifer Copper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669882742 PECOS PAC ID: 5890911101 Enrollment ID: I20140723000341 |
| Provider Name | Katherine Smith Herzog |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366603326 PECOS PAC ID: 1153581764 Enrollment ID: I20140820002223 |
| Provider Name | Brian C Helmly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518127232 PECOS PAC ID: 2365682143 Enrollment ID: I20140826002921 |
| Provider Name | Mary Mccartney Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326138413 PECOS PAC ID: 5991925976 Enrollment ID: I20140926000800 |
| Provider Name | Bethany Rennaye Norwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740685577 PECOS PAC ID: 6305168386 Enrollment ID: I20141202000830 |
| Provider Name | Jeanette Susan Pirkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033459482 PECOS PAC ID: 0941525901 Enrollment ID: I20150213001932 |
| Provider Name | Saima Nazily Hussain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689800286 PECOS PAC ID: 5597082875 Enrollment ID: I20150325001965 |
| Provider Name | Emily Louanne Mcgahee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942683941 PECOS PAC ID: 0143537506 Enrollment ID: I20150916003574 |
| Provider Name | Kara Schneider Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700808235 PECOS PAC ID: 5496063935 Enrollment ID: I20151001002247 |
| Provider Name | Rebecca B Ando |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396988754 PECOS PAC ID: 7416191887 Enrollment ID: I20160105000562 |
| Provider Name | Leigh Anne Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720327216 PECOS PAC ID: 1557663655 Enrollment ID: I20160106002127 |
| Provider Name | Nicole Marie Sachau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215389192 PECOS PAC ID: 2264726306 Enrollment ID: I20160811001764 |
| Provider Name | Mussie Asmerom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285094433 PECOS PAC ID: 5496040024 Enrollment ID: I20160822002389 |
| Provider Name | Heather L Burke-cody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699145060 PECOS PAC ID: 3779879382 Enrollment ID: I20160908000612 |
| Provider Name | Adam D. Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801248489 PECOS PAC ID: 3678861036 Enrollment ID: I20161018001226 |
| Provider Name | Jose Fernando Aycinena |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1245495787 PECOS PAC ID: 0345411906 Enrollment ID: I20161027000980 |
| Provider Name | Allison Harris Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699064733 PECOS PAC ID: 5294002853 Enrollment ID: I20170601002643 |
| Provider Name | Andrew T Johnson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497045553 PECOS PAC ID: 5395043863 Enrollment ID: I20170720002515 |
| Provider Name | Richard Tyler Burgner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053730481 PECOS PAC ID: 0840596821 Enrollment ID: I20171205003165 |
| Provider Name | Cheryl Lynn Thorsten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518471044 PECOS PAC ID: 6709140783 Enrollment ID: I20180426002348 |
| Provider Name | Dhruvkumar Ashokbhai Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881950293 PECOS PAC ID: 2668748674 Enrollment ID: I20180625003370 |
| Provider Name | Connie Francia Osorio |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326468604 PECOS PAC ID: 9436448651 Enrollment ID: I20180702000159 |
| Provider Name | Barbara E Oess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659610731 PECOS PAC ID: 0840547550 Enrollment ID: I20180725002992 |
| Provider Name | Michael Carmen Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235251554 PECOS PAC ID: 0648448407 Enrollment ID: I20180806002347 |
| Provider Name | Gina Zeidman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518337708 PECOS PAC ID: 0749530046 Enrollment ID: I20180907000576 |
| Provider Name | D'anna Cain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538653829 PECOS PAC ID: 9537419833 Enrollment ID: I20180907000705 |
| Provider Name | Jeffrey Scott Wieseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578040523 PECOS PAC ID: 7416208749 Enrollment ID: I20180925002441 |
| Provider Name | Oteia Keion Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710431226 PECOS PAC ID: 4082992227 Enrollment ID: I20181017000636 |
| Provider Name | Hugh Colby Cornelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053899682 PECOS PAC ID: 2062766827 Enrollment ID: I20181113003452 |
| Provider Name | Adam Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427379726 PECOS PAC ID: 4486908027 Enrollment ID: I20181116001474 |
| Provider Name | Christy A Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134404072 PECOS PAC ID: 2961746029 Enrollment ID: I20181130001984 |
| Provider Name | Brandon Roehll Runyan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225012198 PECOS PAC ID: 9638223985 Enrollment ID: I20190129001933 |
| Provider Name | Madeleine Delportillo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174609390 PECOS PAC ID: 9830438696 Enrollment ID: I20190222001537 |
| Provider Name | Calvin Edward Defenbau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265927362 PECOS PAC ID: 2769721471 Enrollment ID: I20190225001193 |
| Provider Name | Jacquelyn Miranda Trammell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730644980 PECOS PAC ID: 5496095564 Enrollment ID: I20190327002828 |
| Provider Name | Elizabeth Belle Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255895009 PECOS PAC ID: 3274873377 Enrollment ID: I20190328000770 |
| Provider Name | Michelle Johnson Nastav |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194283531 PECOS PAC ID: 4385985563 Enrollment ID: I20190417000214 |
| Provider Name | Daniel Jose Torrent |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285920322 PECOS PAC ID: 2860790383 Enrollment ID: I20190819004003 |
| Provider Name | Shelia H Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194382994 PECOS PAC ID: 1052643483 Enrollment ID: I20191104002208 |
| Provider Name | Britta Adwoa Okyere |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306231535 PECOS PAC ID: 4082924071 Enrollment ID: I20191212001954 |
| Provider Name | James Brown Gilbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093927097 PECOS PAC ID: 9234484247 Enrollment ID: I20200414001505 |
| Provider Name | Kathryn Deluise Liccardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497380497 PECOS PAC ID: 4880025816 Enrollment ID: I20200507001582 |
| Provider Name | Kevin Douglas Waits |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1912235888 PECOS PAC ID: 3678712627 Enrollment ID: I20200627000093 |
| Provider Name | Kelly Nicole O'dell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700226131 PECOS PAC ID: 3274759451 Enrollment ID: I20200708003618 |
| Provider Name | Sook Kyung Yoon |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629459136 PECOS PAC ID: 4587968250 Enrollment ID: I20200803000904 |
| Provider Name | Yamin Sun |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801216080 PECOS PAC ID: 1951676550 Enrollment ID: I20200804003156 |
| Provider Name | Amanda Hoerler Burnham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184974313 PECOS PAC ID: 2466877469 Enrollment ID: I20200807002438 |
| Provider Name | Shravanti Macherla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073800629 PECOS PAC ID: 7719106574 Enrollment ID: I20200812003848 |
| Provider Name | Sreeja Gopinathan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184158628 PECOS PAC ID: 9436576840 Enrollment ID: I20200831003170 |
| Provider Name | Lisha A Lansberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932699436 PECOS PAC ID: 0244587368 Enrollment ID: I20200922002534 |
| Provider Name | Maria Mercedes Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972105179 PECOS PAC ID: 1850704255 Enrollment ID: I20210104000457 |
| Provider Name | Whitney Leanne Dockery |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407443575 PECOS PAC ID: 0547675050 Enrollment ID: I20210216000621 |
| Provider Name | David M Woodbury |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770512311 PECOS PAC ID: 8022048248 Enrollment ID: I20210225002750 |
| Provider Name | Jamie Johnson Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659960680 PECOS PAC ID: 4082029905 Enrollment ID: I20210226000128 |
| Provider Name | Ashley Valentine Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932787827 PECOS PAC ID: 5597173773 Enrollment ID: I20210428001731 |
| Provider Name | Jeffrey Allen Siebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114255593 PECOS PAC ID: 2769883446 Enrollment ID: I20210701002439 |
| Provider Name | Russell Kinshun Fung |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497118285 PECOS PAC ID: 7719285022 Enrollment ID: I20210708000300 |
| Provider Name | Hannah Zucker Roseberry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881057297 PECOS PAC ID: 8628363389 Enrollment ID: I20210727003133 |
| Provider Name | Devi Sampat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104212778 PECOS PAC ID: 9032513544 Enrollment ID: I20210805001591 |
| Provider Name | Ian Christopher Quinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578098240 PECOS PAC ID: 1759653132 Enrollment ID: I20210825000386 |
| Provider Name | Amanda Michelle Herrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760158448 PECOS PAC ID: 6002212578 Enrollment ID: I20210908002893 |
| Provider Name | Eric Joel Velazquez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417272477 PECOS PAC ID: 1355511874 Enrollment ID: I20210927002623 |
| Provider Name | Christopher J Linberg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750390936 PECOS PAC ID: 5294739165 Enrollment ID: I20211025001443 |
| Provider Name | Venumadhav Kotla |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1194983122 PECOS PAC ID: 0749337780 Enrollment ID: I20211027001393 |
| Provider Name | Tyler Mckinnon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205272408 PECOS PAC ID: 2860796919 Enrollment ID: I20220112001593 |
| Provider Name | Amanda Kay Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831153220 PECOS PAC ID: 9931596483 Enrollment ID: I20220502000648 |
| Provider Name | Jennifer Kelly Anderson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457748451 PECOS PAC ID: 1153629795 Enrollment ID: I20220622003240 |
| Provider Name | John William Perry |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306379813 PECOS PAC ID: 7416227731 Enrollment ID: I20220720004034 |
| Provider Name | Algernon William Prioleau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518462654 PECOS PAC ID: 7012241169 Enrollment ID: I20220721002855 |
| Provider Name | Sonali Ganguly |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215666862 PECOS PAC ID: 9537541057 Enrollment ID: I20220801000838 |
| Provider Name | Ryan D Berry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154881118 PECOS PAC ID: 6608117924 Enrollment ID: I20220808001168 |
| Provider Name | Smit Jayesh Jani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093246738 PECOS PAC ID: 3274805619 Enrollment ID: I20221014000083 |
| Provider Name | Abigail Love Strike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063134997 PECOS PAC ID: 7911373337 Enrollment ID: I20221026000381 |
| Provider Name | Leslie Stephens Brewer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1346963790 PECOS PAC ID: 3274901830 Enrollment ID: I20221201003008 |
| Provider Name | Destiny D Gilder |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1134832686 PECOS PAC ID: 2365813219 Enrollment ID: I20230201000354 |
| Provider Name | Emily Nicole Jones |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1558940544 PECOS PAC ID: 0345613196 Enrollment ID: I20230227002192 |
| Provider Name | Jessica Leigh Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659070324 PECOS PAC ID: 3577920032 Enrollment ID: I20230530000318 |
| Provider Name | Anjelica Jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568126118 PECOS PAC ID: 5991163511 Enrollment ID: I20230614000746 |
| Provider Name | Caleb James Botta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336778901 PECOS PAC ID: 8022493840 Enrollment ID: I20230809003843 |
| Provider Name | Joseph Martin Roberts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396372496 PECOS PAC ID: 8022470814 Enrollment ID: I20230810001943 |
| Provider Name | Rychelle Nicole Magriby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366041873 PECOS PAC ID: 9537579693 Enrollment ID: I20230901003186 |
| Provider Name | Crystal Lavada Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194508309 PECOS PAC ID: 7012371834 Enrollment ID: I20230913000612 |
| Provider Name | Kristi Lee Grabill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346931490 PECOS PAC ID: 9436513108 Enrollment ID: I20230913003083 |
| Provider Name | Inquashia Latrice Shaw |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962039909 PECOS PAC ID: 2163886862 Enrollment ID: I20230914000174 |
| Provider Name | Jasmeet Kaur Kataria-hale |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912343476 PECOS PAC ID: 1456651264 Enrollment ID: I20230920001768 |
| Provider Name | Mary Catherine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891578555 PECOS PAC ID: 2668828153 Enrollment ID: I20231019000486 |
| Provider Name | Patrick Mullinix |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306268529 PECOS PAC ID: 6305176611 Enrollment ID: I20231023002763 |
| Provider Name | Kayleigh Dyches Biskup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144909839 PECOS PAC ID: 6901252238 Enrollment ID: I20231024000088 |
| Provider Name | Joshua Phillip Bloodworth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730684358 PECOS PAC ID: 2062742695 Enrollment ID: I20240411001307 |
| Provider Name | Benjamin Goldsmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902302466 PECOS PAC ID: 9335496462 Enrollment ID: I20240426001856 |
| Provider Name | Alison Evans Finnerty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124538194 PECOS PAC ID: 2769928951 Enrollment ID: I20240724001424 |
| Provider Name | Mary Hannah Read |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033673728 PECOS PAC ID: 5193052736 Enrollment ID: I20240730002525 |
| Provider Name | Delaney Jarrett Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346089976 PECOS PAC ID: 3779020631 Enrollment ID: I20240808004647 |
| Provider Name | Laura Elaine Cupp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821847393 PECOS PAC ID: 3476091067 Enrollment ID: I20240814001034 |
| Provider Name | Maurice Alexander Asouzu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972063394 PECOS PAC ID: 1456693514 Enrollment ID: I20240830002522 |
| Provider Name | Pooja Mayur Sampat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558949347 PECOS PAC ID: 5193128692 Enrollment ID: I20241122000653 |
| Provider Name | Madison Saxon Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952034340 PECOS PAC ID: 6305376120 Enrollment ID: I20250210001321 |
| Provider Name | Ashwin Thaiaigavara Ram |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477737930 PECOS PAC ID: 1658518550 Enrollment ID: I20250316000079 |
| Provider Name | James Howard Mitchell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164905147 PECOS PAC ID: 6406184134 Enrollment ID: I20250410002586 |
| Provider Name | Ximena Ariela Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326757428 PECOS PAC ID: 5698292746 Enrollment ID: I20250512002631 |
William T. Jones, M.d.,pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1098 S Enota Dr Ne, Gainesville, GA 30501 Phone: 770-532-4517 Fax: 770-503-0267 | |
Dr Johnny J Di Blasi Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Washington Ave, Gainesville, GA 30501 Phone: 904-482-9673 | |
Primary Care Clinics Of Georgia Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1240 Jesse Jewell Pkwy Se, Suite 370, Gainesville, GA 30501 Phone: 770-536-1004 Fax: 770-536-0905 | |
Hall County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1290 Athens St, Gainesville, GA 30507 Phone: 770-532-5344 | |
Gastroenterology Associates Of Gainesville, P. C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2324 Limestone Overlook, Gainesville, GA 30501 Phone: 770-536-8109 Fax: 770-536-3203 | |
Annual Wellness Centers Of America Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3030 Mcever Rd, Suite 300, Gainesville, GA 30504 Phone: 770-503-0021 | |
Ortho Sport & Spine Gainesville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1990 Limestone Cir, Gainesville, GA 30501 Phone: 678-752-7246 |