CHAELI WISENBAKER (NPI# 1003229568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003229568 |
| Entity Type | Individual |
| Full Name | CHAELI WISENBAKER |
| Other Name | CHAELI NELSON |
| Credential | PA-C |
| Practice Address |
2412 N Oak St Valdosta GA 31602-2567 |
| Mailing Address |
3832 Dane Ln Valdosta GA 31601 |
| Practice Telephone | 2292441400 |
| Practice Fax Number | 2292445512 |
| Mailing Telephone | 2297403604 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2016-05-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA LICENSE | 7207 | 01 |
| Street Address |
2412 N OAK ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093759011 | Matthew Allan Thomas | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2006-06-16 |
| 1992335855 | Lindsey Dickinson | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2020-01-20 |
| 1760028856 | Rachel Bennefield | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2019-11-23 |
| 1558846121 | Anna C Vaggalis | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-09-30 |
| 1972093185 | Jordan Ganas | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-05-14 |
| 1356847743 | Timothy Blake Taylor | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-04-04 |
| 1831607670 | Jessica Taylor | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2018-01-15 |
| 1730546326 | Charles Earl Watts Jr. | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2016-01-27 |
| 1679962807 | Caroline Hendley | Nurse Practitioner | 2412 N Oak St, Valdosta, GA 31602-2567 | 2015-01-12 |
| 1548662505 | Kathryn Marie Woltz | Physician Assistant | 2412 N Oak St, Valdosta, GA 31602-2567 | 2014-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881098283 | Allison Marie Wegmann | Physician Assistant | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2014-10-14 |
| 1659666063 | Jesse Blair Eason | Physician Assistant | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2011-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.