JEREMY BAGGE (NPI# 1023085974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023085974 |
| Entity Type | Individual |
| Full Name | JEREMY BAGGE |
| Credential | PA-C |
| Practice Address |
11 Charlie Morris Rd Medlink Colbert Colbert GA 30628-2445 |
| Mailing Address |
P.o. Box 495 Medlink Georgia Colbert GA 30628-0459 |
| Practice Telephone | 7067882127 |
| Practice Fax Number | 7067882815 |
| Mailing Telephone | 7067883234 |
| Mailing Fax Number | 7067882936 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2012-02-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
006329 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11 CHARLIE MORRIS RD MEDLINK COLBERT |
| City | COLBERT |
| State | GA |
| Zip Code | 30628-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588642771 | Nicole Ford | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2006-01-06 |
| 1477176600 | Dallas Louis | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2020-05-21 |
| 1144849233 | Sarah Sammons | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2020-04-09 |
| 1174184030 | Evan Grovenstein | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2019-06-21 |
| 1245732254 | Medlink Georgia Inc | Pharmacy | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2018-03-06 |
| 1801248182 | Jordan Hoffman | Social Worker | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2016-07-11 |
| 1720451222 | Candace Vandiver | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2015-11-05 |
| 1295172773 | Matthew Davis | Family Medicine | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2013-05-24 |
| 1336492503 | Nora Ann Blankenship | Social Worker | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2012-10-24 |
| 1972897700 | Akilah S Tomingas | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326173956 | Jonathan Marc Perry | Pharmacist | 15 Colbert Business Parkway, Fred's Pharmacy #1394, Colbert, GA 30628 | 2007-02-22 |
| 1366938086 | Preston Gantt, Md, Sa-c | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-07-05 |
| 1902304538 | Preston Gantt | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-01-29 |
| 1134559958 | Manuel Garcia-gaona | Physical Therapist | 19 Dogwood Dr, Colbert, GA 30628-1512 | 2013-11-14 |
| 1720353675 | Innovative Medical Group | Durable Medical Equipment & Medical Supplies | 232 Jeremy Dr, Colbert, GA 30628-1543 | 2012-03-11 |
| 1154399152 | Amanda Griffin Wagner | Psychologist | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2006-03-08 |
| 1669951414 | Medlink Georgia Inc | Clinic/Center | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2018-08-13 |
| 1033449665 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 15 Colbert Business Pkwy W, Colbert, GA 30628-2462 | 2010-01-04 |
| 1104134469 | Southern Medical Transport | Non-emergency Medical Transport (VAN) | 276 Kincaid Cemetery Rd, Colbert, GA 30628-2547 | 2010-09-21 |
| 1447443361 | Robyn Cain Crouse | Physical Therapist | 1450 Old Kincaid Rd, Colbert, GA 30628-2559 | 2007-08-23 |
| Find all providers in zip 30628 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| 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.